Addressing the challenges of ECMO simulation

Abstract

Introduction/Aim: The patient’s condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with critical situations. Simulation-based education (SBE), from the simplest approaches to the most immersive modalities, helps promote optimum individual and team performance. The risks of SBE are negative learning, inauthenticity in learning and over-reliance on the participants’ suspension of disbelief. This is especially relevant to ECMO SBE as circuit/patient interactions are difficult to fully simulate without confusing circuit alterations. Methods: Our efforts concentrate on making ECMO simulation easier and more realistic in order to reduce the current gap there is between SBE and real ECMO patient care. Issues to be overcome include controlling the circuit pressures, system failures, patient issues, blood colour and cost factors. Key to our developments are the hospital-university collaboration and research funding. Results: A prototype ECMO simulator has been developed that allows for realistic ECMO SBE. The system emulates the ECMO machine interface with remotely controllable pressure parameters, haemorrhaging, line chattering, air bubble noise and simulated blood colour change. Conclusion: The prototype simulator allows the simulation of common ECMO emergencies through innovative solutions that enhance the fidelity of ECMO SBE and reduce the requirement for suspension of disbelief from participants. Future developments will encompass the patient cannulation aspect.

Cost-Effective Extracorporeal Membrane Oxygenation Simulation

“…There are few commercial options for ECMO simulation and many limitations to these systems and those developed in-house across the globe. 37 The ECMO simulation system being developed in Qatar is hoped to make a significant impact in this relatively niche market in terms of training opportunities and offerings due to its relative affordability, the modular approach used, and the high level of realism it offers. 41 Providing a simulator platform that affords rehearsing cases from pre-ECMO patient selection, ECMO circuit troubleshooting, through to decannulation in a highly realistic manner, provides a novel and valuable training opportunity that should significantly contribute to developing the skills of ECMO clinicians and enhance patient safety.…”

“…34 Until now, immersive or full-scale ECMO simulation has totally relied on using real medical devices for training purposes, with customized circuits connected to a patient simulator to allow for manipulation of pressures and recreate various patient-or circuit related emergency situations. [35][36][37] Some commercial products have also emerged on the market (e.g., Parallel Simulator by Chalice Medical Ltd. and EigenFlow ECMO Simulator by Curtis Life Research), but they also rely on the use of the real ECMO machine and its expensive disposable components. There are also many aspects of ECMO care principles that can be effectively taught and practiced through water drills using the basic circuit components, but it provides a far less immersive and contextualized learning experience than simulation modalities also involving a patient simulator.…”

Preliminary Implementation of the Next Generation Cannulation Simulator

“…1 [9]. Based on the identified limitations of the current simulators, the HMC team started to work on a new design to provide a better training experience and initiated the collaboration with an engineering team from Qatar University [10].…”

Extracorporeal membrane oxygenation simulation-based training: methods, drawbacks and a novel solution

“…Simulated ECMO scenarios, methods of simulation, induced cues and gaps and drawbacks. 5,38,39,[41][42][43][44][45] . Battery alarm triggers if the battery was drained beforehand.…”