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Background Despite the growing use of extracorporeal membrane oxygenation (ECMO) in intensive care units (ICUs), no standardized ECMO training pathways are available for ECMO-naive critical care nurses. Objectives To evaluate a critical care nurse ECMO curriculum that may be reproducible across institutions. Methods An ECMO curriculum consisting of a basic safety course and an advanced user course was designed for critical care nurses. Courses incorporated didactic and simulation components, written knowledge examinations, and electronic modules. Differences in examination scores before and after each course for the overall cohort and for participants from each ICU type were analyzed with t tests or nonparametric equality-of-medians tests. Differences in postcourse scores across ICU types were examined with multiple linear regression. Results Critical care nurses new to ECMO (n = 301) from various ICU types participated in the basic safety course; 107 nurses also participated in the advanced user course. Examination scores improved after completion of both courses for overall cohorts (P < .001 in all analyses). Median (interquartile range) individual score improvements were 23.1% (15.4%-38.5%) for the basic safety course and 8.4% (0%-16.7%) for the advanced user course. Postcourse written examination scores stratified by ICU type, compared with the medical ICU/cardiovascular ICU group (reference group), differed only in the neurovascular ICU group for the basic safety course (percent score difference, −3.0; 95% CI, −5.3 to −0.8; P = .01). Conclusions Implementation of an ECMO curriculum for a high volume of critical care nurses is feasible and effective.

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Heparin-induced thrombocytopenia paradoxically is a transient pro-thrombotic disorder triggered by heparin exposure. If not treated appropriately, it can be life threatening because of its related thromboembolic complications. In particular, it presents a unique challenge in patients needing extracorporeal life support, because anticoagulation is essential for safe management. This case report describes the safe, efficacious use of Argatroban during short-term support of a patient with a percutaneously inserted left ventricular assist TandemHeart device.