The ECMO specialist’s role in troubleshooting ECMO emergencies

Whether a patient still has native lung function or not, respiratory extracorporeal membrane oxygenation (ECMO) complications need an immediate response from the ECMO team assigned to the patient. Methodological troubleshooting can be a key aspect to responding to an ECMO emergency if the cause of the issue is not clearly identifiable. To decrease the incidence of ECMO emergencies clear procedures must be in place and the ECMO team must be continuously trained through a variety of approaches before attempting to put a patient on ECMO or being given the responsibility of looking after such patient. Procedures that meet Extracorporeal Life Support Organization (ELSO) standards, a sufficient level of ECMO activity, and adequate competency of the clinicians are key to the success of an ECMO program. Both procedures and clinicians can be informed and tested using didactic sessions, focus group discussions, scenario-based simulations, water drills, bedside education, and case debriefings. Such activities should be ongoing and with adequate support for monitoring of skills validation, commonly faced issues, and patient outcomes.