First, let’s give definition to the role of an ECMO Specialist. ELSO offers a guideline (last update: 2010) providing some definition stating that an ECMO Specialist is the technical specialist trained to manage the ECMO system and the clinical needs of the patient on ECMO under the direction and supervision of a licensed ECMO trained physician. They recommend a specialist have a strong critical care background in neonatal, pediatric, and/or adult critical care and also be a registered nurse, registered respiratory therapist, perfusionist, bio engineer or physician who has completed training in the ECMO specialty.

I think we can agree that this is a broad definition, left so that medical centers can steer their way through what would best accommodate the individual needs of an ECMO program. It is also a guideline last revised 14 years ago.

A lot has happened in the world of ECMO over the last 14 years. The rapid growth of adult ECMO programs with H1N1 in 2009, medical centers figuring out how to incorporate ECMO into their treatment option, COVID 19 in 2020, ECPR for out of hospital and in hospital cardiac arrest, and much more. Importantly, documented ECMO centers have dramatically increased since 2010.

This leads to the question, who is really responsible for managing the ECMO system and clinical needs of the patient? The ECMO Specialist. But just how is the ECMO Specialist role growing, developing and being trained? This is a great question that will be discussed in upcoming posts.

An ECMO Specialist is a necessary part of the team. Whether that role is taken on by a nurse, respiratory therapist, perfusionist or physician varies around the world. There is no question that the role is essential.

Being an ECMO Specialist includes some of the following responsibilities:

🔹 educates the care team, patient and others about ECMO

🔹 assists the physician during cannulation

🔹 understands the principles of extracorporeal circulation and various cannulation configuration options

🔹 interprets ABG’s and makes adjustments to the blender

🔹 performs circuit and oxygenator exchanges as indicated

🔹 evaluates the patient’s readiness for weaning

🔹 rinses back blood during decannulation

🔹 connects and disconnects CRRT and hemofilters

🔹 ensures proper securement and positioning of cannula

🔹 manages the circuit and settings during mobility

🔹 primes new circuits

🔹 collaborates with the team to optimize appropriate ventilator, medication infusion and other mechanical circulatory support devices

🔹 travels to outside hospitals to assist with cannulation, stabilization and transport to the receiving facility

… and much more

The responsibilities are dynamic and make an impact in care provided by an ECMO center.

Follow along as we explore more about the ECMO Specialist’s role, function, training needed and more.