High-fidelity simulation — the first DCD-ECMO procedure in Poland

Puslecki, Mateusz; Ligowski, Marcin; Dąbrowski, Marek; Sip, Maciej; Stefaniak, Sebastian; Kłosiewicz, Tomasz; Gąsiorowski, Łukasz; Karczewski, Marek; Małkiewicz, Tomasz; Ładzińska, Małgorzata; Zieliński, Marcin; Pawlak, Aleksander; Dąbrowska, Agata; Ziemak, Piotr; Perek, Bartłomiej; Misterski, Marcin; Katarzyński, Sławomir; Buczkowski, Piotr; Telec, Wojciech; Kiel-Puślecka, Ilona; Kiel, Michał; Czekajło, Michael; Jemielity, Marek

doi:10.5603/demj.2017.0009

Cited by 7 publications

(10 citation statements)

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“…It included capability to verify the patient and ECMO indication, to perform cannulation, to prime the ECMO circuit, and to initiate ECMO treatment (17,(46)(47)(48)(49)(50)(51). The above simulations were carried out in this scope and form for the first time in Poland and Europe, and they have become an excellent training tool allowing to create procedures that have not been carried out so far.…”

Section: Elso Guidelines For Education and Medical Simulationmentioning

confidence: 99%

“…In addition with creating a mobile ECMO team we tested all responsibilities that are needed for the mission. It included capability to verify the patient and ECMO indication, to perform cannulation, to prime the ECMO circuit, and to initiate ECMO treatment (17,(46)(47)(48)(49)(50)(51).…”

Section: Elso Guidelines For Education and Medical Simulationmentioning

confidence: 99%

“…Medical simulation is a great tool to test improving the quality of education while acquiring skills. In Poland and in the region, we are only dealing with the implementation and development of perfusion techniques in the treatment of critical conditions (17,(46)(47)(48)(49)(50)(51). In this respect, we must be aware of the related limitations.…”

Section: Elso Guidelines For Education and Medical Simulationmentioning

confidence: 99%

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BEST Life—“Bringing ECMO Simulation To Life”—How Medical Simulation Improved a Regional ECMO Program

et al. 2018

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The implemented "ECMO for Greater Poland" program takes full advantage of the ECMO (extracorporeal membrane oxygenation) perfusion therapy to promote health for 3.5 million inhabitants in the region. The predominant subjects of implementation are patients with hypothermia, with severe reversible respiratory failure (RRF), and treatment of other critical states leading to heart failure such as sudden cardiac arrest, cardiogenic shock or acute intoxication. Finally, it promotes donation after circulatory death (DCD) strategy in selected organ donor cases. ECMO enables recovery of organs' function after unsuccessful lifesaving treatment. Because this organizational model is complex and expensive, we use advanced high-fidelity medical simulation to prepare for real-life implementation. During the first four months, we performed scenarios mimicking "ECMO for DCD," "ECMO for ECPR (extended cardiopulmonary resuscitation)," "ECMO for RRF" and "ECMO in hypothermia." It helped to create algorithms for aforementioned program arms. In the following months, three ECMO courses for five departments in Poznan (capitol city of Greater Poland) were organized and standardized operating procedures for road ECMO transportation within Medical Emergency System were created. Soon after simulation program, 38 procedures with ECMO perfusion therapy including five road transportations on ECMO were performed. The Maastricht category II DCD procedures were done four times on real patients and in two cases double successful kidney transplantations were carried out for the first time in Poland. ECMO was applied in two patients with hypothermia, nine adult patients with heart failure, and five with RRF, for the first time in the region. In the pediatric group, ECMO was applied in four patients with RRF and 14 with heart failure after cardiac surgery procedures. Additionally, one child was treated successfully following 200 km-long road transport on ECMO. We achieved good and promising results especially in VV ECMO therapy. Simulation-based training enabled us to build a successful procedural chain, and to eliminate errors at the stage of identification, notification, transportation, and providing ECMO perfusion therapy. We discovered the important role of medical simulation, not only to test the medical professional's skills, but also to promote ECMO therapy in patients with critical/life-threatening states. Moreover, it also resulted in increase of the potential organ pool from DCD in the Greater Poland region.

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Section: Elso Guidelines For Education and Medical Simulationmentioning

confidence: 99%

Section: Elso Guidelines For Education and Medical Simulationmentioning

confidence: 99%

Section: Elso Guidelines For Education and Medical Simulationmentioning

confidence: 99%

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BEST Life—“Bringing ECMO Simulation To Life”—How Medical Simulation Improved a Regional ECMO Program

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“…Simulation-based teaching and regularly training of healthcare providers is fundamental (3)(4)(5). High-fidelity simulation is used to simulate and train rare procedures and emergency situations and finally to familiarize healthcare providers with ECMO specific treatments and strategies (6). Different ECMO simulators have been used in the past, ranging from simple mannequin modifications to high-fidelity simulators (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Prototype of extracorporeal membrane oxygenation (ECMO) therapy simulator used in regional ECMO program

Puslecki¹,

Ligowski²,

Kiel³

et al. 2018

J. Thorac. Dis.

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This newly developed advanced ECMO simulation prototype was recently introduced into education and regularly training of healthcare providers of the "ECMO for Greater Poland" program. The simulation based training program is financially affordable and enables clinical teaching in a wider range of clinical scenarios. The ECMO simulation prototype consequently improves level of expertise of the healthcare providers and finally improves quality in patient care.

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“…One of the approved clinical indications of the regional ECMO program is the implementation of ECMO as a support for organ perfusion in donors after circulatory death (DCD) DCD-ECMO. 1,2 We describe the first in-situ simulation scenario that led to Poland's first case of organ (kidney) transplantation from a donor after circulatory death in which organs were recovered by ECMO. [3][4][5] Because of the logistical complexity and cost, we developed an ECMO simulator and used advanced highfidelity medical simulation to prepare for real-life implementation.…”

Section: Introductionmentioning

confidence: 99%

The role of simulation to support donation after circulatory death with extracorporeal membrane oxygenation (DCD-ECMO)

et al. 2017

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Maintaining the viability of organs from donors after circulatory death (DCD) for transplantation is a complicated procedure, from a time perspective in the absence of appropriate organizational capabilities, that makes such transplantation cases difficult and not yet widespread in Poland. We present the procedural preparation for Poland's first case of organ (kidney) transplantation from a DCD donor in which perfusion was supported by extracorporeal membrane oxygenation (ECMO). Because this organizational model is complex and expensive, we used advanced high-fidelity medical simulation to prepare for the real-life implementation. The real time scenario included all crucial steps: prehospital identification, cardiopulmonary resuscitation (CPR), advanced life support (ALS); perfusion therapy (CPR-ECMO or DCD-ECMO); inclusion and exclusion criteria matching, suitability for automated chest compression; DCD confirmation and donor authorization, ECMO organs recovery; kidney harvesting. The success of our first simulated DCD-ECMO procedure in Poland is reassuring. Soon after this simulation, Maastricht category II DCD procedures were performed, involving real patients and resulting in two successful double kidney transplantations. During debriefing, it was found that the previous simulation-based training provided the experience to build a successful procedural chain, to eliminate errors at the stage of identification, notification, transportation, donor qualifications and ECMO organ perfusion to create DCD-ECMO algorithm architecture.

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High-fidelity simulation — the first DCD-ECMO procedure in Poland

Cited by 7 publications

References 5 publications

BEST Life—“Bringing ECMO Simulation To Life”—How Medical Simulation Improved a Regional ECMO Program

BEST Life—“Bringing ECMO Simulation To Life”—How Medical Simulation Improved a Regional ECMO Program

Prototype of extracorporeal membrane oxygenation (ECMO) therapy simulator used in regional ECMO program

The role of simulation to support donation after circulatory death with extracorporeal membrane oxygenation (DCD-ECMO)

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