ECMO Specialist

Summary

Provides clinical patient care assessment, initiation, modifications, and weaning of Extracorporeal Membrane Oxygenation (ECMO), also referred to as Extracorporeal Life Support (ECLS), to neonatal, pediatric, and adult patient populations at Rhode Island Hospital and Hasbro Children’s in collaboration with a licensed physician with expertise in ECMO.

Evaluates, assesses, and performs prescribed clinical procedures and therapy by order of a licensed medical provider. Works under the general supervision of the ECMO Manager, Respiratory Clinical Supervisors, and Managers of the Respiratory Care Department. Analyzes and evaluates clinical patient data to determine the appropriate therapy or intervention, offers recommendations on patient care to the medical staff, and modifies therapy as appropriate based on patient physiology and response.

Accepts verbal orders from physicians, nurse practitioners, and/or physician assistants where appropriate. Assists the physician in the initiation of ECMO, assembles, primes, and evaluates the acid/base status of the ECMO circuit. Analyzes and evaluates clinical patient data to determine appropriate adjustments to the ECMO system and maintains prescribed parameters for acid‑base balance, anticoagulation, circuit pressures, platelets, hematocrit, and temperature. Participates in bedside rounds to review, discuss, and recommend preferred treatment methods for patients.

Responsible for initiation, delivery, and discontinuation of all medications and blood products delivered through the ECMO system. Monitors, evaluates, and adjusts anticoagulation therapy under direction of the physician. Coordinates and accompanies ECMO patients while on intra‑ and inter‑hospital transport. Continuously monitors, assesses, and evaluates patients on ECMO to maintain safety. Responsible for maintaining up to two ECMO patients simultaneously. Provides clinical instruction on the proper use of ECMO equipment, related procedures, and management to other health care providers.

Evaluates, assesses, monitors, maintains, and troubleshoots equipment used for the delivery of ECMO. Maintains and ensures the availability and functionality of a standby ECMO circuit and all emergency ECMO equipment at the bedside for any circuit emergency. Participates in all comprehensive in‑house orientation and competency training in ECMO and related procedures. When not functioning as an ECMO Specialist, functions as a staff respiratory therapist, evaluating and assessing clinical appropriateness, efficacy, and responses to basic and medically complex respiratory care procedures in patients with cardiopulmonary related difficulties.

Assesses, evaluates, and provides complex intensive respiratory care and mechanical ventilation in all patient populations within the acute intensive care areas. Provides safe and effective service to the Code Response Team, Rapid Response/Fast Team, and the high‑risk transport of ECMO patients to/from outlying facilities (Life Pact). Provides expert care in the use of high‑frequency ventilation, bronchoscopy assistance, percutaneous tracheostomy procedures, nitric oxide delivery, heliox or other medical gas delivery.

Participates in approved IRB medical research projects. Cleans and restocks pump and equipment cart after discontinuation of ECMO support following all hospital policies regarding infection control and bio‑hazard waste procedures when caring for and disposing of circuit components. Assembles all components, monitors, evaluates, and assesses the SCUF to ECMO interface. Participates in departmental quality improvement activities, including documenting variances that occur during the administration of ECMO.

Attends ECMO staff meetings for case peer review and in‑service education. Provides in‑service education for other health care professionals. Performs periodic practice primes, wet drills, and simulation activities. Records pertinent data on flow sheets/EMR and writes shift notes. Safeguards the privacy of all patients and protects the confidentiality of their health information.

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