Extracorporeal Membrane Oxygenation in Transport Part 2: Complications and Troubleshooting

Vieira, Jennifer; Frakes, Michael A.; Cohen, Jason; Wilcox, Susan R.

doi:10.1016/j.amj.2019.09.009

Cited by 23 publications

(17 citation statements)

References 27 publications

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“…Modern air ambulance services are able to provide advanced interventions during transport, including intensive care procedures, differentiated catecholamine therapy, volume resuscitation, modern ventilation strategies, ECMO, inhaled nitric oxide, or even the use of heart-assisted devices (e.g. like Impella®) during transport [ 12 – 15 ]. Several guidelines recommend the use of ECMO or inhaled nitric oxide in selected COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

Hilbert-Carius

Braun²,

Abu‐Zidan

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background COVID-19, the pandemic caused by the severe acute respiratory syndrome coronavirus-2, is challenging healthcare systems worldwide. Little is known about problems faced by emergency medical services—particularly helicopter services—caring for suspected or confirmed COVID-19 patients. We aimed to describe the issues faced by air ambulance services in Europe as they transport potential COVID-19 patients. Methods Nine different HEMS providers in seven different countries across Europe were invited to share their experiences and to report their data regarding the care, transport, and safety measures in suspected or confirmed COVID-19 missions. Six air ambulance providers in six countries agreed and reported their data regarding development of special procedures and safety instructions in preparation for the COVID-19 pandemic. Four providers agreed to provide mission related data. Three hundred eighty-five COVID-19-related missions were analysed, including 119 primary transport missions and 266 interfacility transport missions. Results All providers had developed special procedures and safety instructions in preparation for COVID-19. Ground transport was the preferred mode of transport in primary missions, whereas air transport was preferred for interfacility transport. In some countries the transport of COVID-19 patients by regular air ambulance services was avoided. Patients in interfacility transport missions had a significantly higher median (range) NACA Score 4 (2-5) compared with 3 (1-7), needed significantly more medical interventions, were significantly younger (59.6 ± 16 vs 65 ± 21 years), and were significantly more often male (73% vs 60.5%). Conclusions All participating air ambulance providers were prepared for COVID-19. Safe care and transport of suspected or confirmed COVID-19 patients is achievable. Most patients on primary missions were transported by ground. These patients were less sick than interfacility transport patients, for whom air transport was the preferred method.

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Section: Discussionmentioning

confidence: 99%

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

Hilbert-Carius

Braun²,

Abu‐Zidan

et al. 2020

Scand J Trauma Resusc Emerg Med

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“…Anticoagulation is required to prevent thrombotic complications during ECMO treatment. 26 27 The nurse draws blood each hour to check patient’s coagulation panel: activated clotting time and the activated partial thromboplastin time. We could use flashlight to check for any thrombosis at the end of membranous lung or in the pipeline.…”

Section: Monitoring Patients On Ecmomentioning

confidence: 99%

Donning and doffing of personal protective equipment protocol and key points of nursing care for patients with COVID-19 in ICU

Chen

2020

Stroke Vasc Neurol

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Coronavirus pandemic is the most important public health event in the world currently. Patients with coronavirus disease 2019 (COVID-19) in a critical state are at risk of progressing rapidly into many serve complications; they require a high level of care from ICU nurses. How to avoid the virus to infect health care worker is also a critical issue. Based on the summarized experience of Chinese health workers, literature review and clinical practice, this article introduced donning and doffing of personal protective equipment (PPE) protocol and some keypoints of nursing critical care in patients with coronavirus disease 2019 (COVID-19): caring of patients requiring intubation and ventilation, venous thromboembolism (VTE) prevention, caring of patients on ECMO, caring for patients requiring enteral nutrition, psychological support and nursing management of COVID-19 ICU. This article introduced a useful protocol of donning and doffing personal protective equipment to protect health care workers, and provided key points for the ICU nurses how to take care of COVID-19 patients.

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“…The Extracorporeal Life Support Organization (ELSO) estimated that in 2018 the survival rates of respiratory and circulatory support by ECMO were 58.7% to 73.2% and 42.7% to 52.6%, respectively [ 37 ]. Even with the continuous improvement of technology, the incidence of complications and mortality still remains high in ECMO treatment [ 38 ]. ECMO is a highly complex and sophisticated form of life support performed in specialized, experienced referral centers.…”

Section: Basic Knowledge Of Ecmomentioning

confidence: 99%

Extracorporeal Membrane Oxygenation (ECMO) in Critically Ill Patients with Coronavirus Disease 2019 (COVID-19) Pneumonia and Acute Respiratory Distress Syndrome (ARDS)

Liang

Ding

et al. 2020

Med Sci Monit

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Extracorporeal Membrane Oxygenation in Transport Part 2: Complications and Troubleshooting

Cited by 23 publications

References 27 publications

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

Donning and doffing of personal protective equipment protocol and key points of nursing care for patients with COVID-19 in ICU

Extracorporeal Membrane Oxygenation (ECMO) in Critically Ill Patients with Coronavirus Disease 2019 (COVID-19) Pneumonia and Acute Respiratory Distress Syndrome (ARDS)

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