ECMO transport: The role of Critical Care Paramedics

An Emergency Amendment to the National Scope of Practice for Paramedics in the Setting of a Global Pandemic

“…15 In other cases, critical care paramedics and certified flight paramedics with additional training play critical roles in managing the critically ill patients as members of interdisciplinary transport teams. 16 With a robust training and quality assurance program, non-critical-care paramedics could be trained to safely initiate and manage ventilators in the transport and non-transport settings. As such, paramedics would become valuable team members and experienced resources within hospitals 17 during times of extreme need, such as the current global pandemic.…”

“…Ventilator use in the out‐of‐hospital environment has generally been limited to the realm of interfacility transfers, with many already managed by nationally registered paramedics who may not have had specialized critical care training 15 . In other cases, critical care paramedics and certified flight paramedics with additional training play critical roles in managing the critically ill patients as members of interdisciplinary transport teams 16 . With a robust training and quality assurance program, non‐critical‐care paramedics could be trained to safely initiate and manage ventilators in the transport and non‐transport settings.…”

Addressing the challenges of ECMO simulation

“…A communality of ECMO teams is that they are multiprofessional and generally include nurses, physicians (intensivist and/or surgeons), respiratory therapists, perfusionists, pharmacists and, sometimes, critical care practitioners or paramedics. [15][16][17][18] They are all specialised in their own fields and play a well-defined and critical role in ensuring the best possible outcome of ECMO patients thanks to their complementary skills. However, there are also common cognitive and practi-cal skills expected from them, so most emergency situations can be dealt with safely and effectively.…”

Nightmares during ECMO run

“…Drug-related issues include hemorrhage from anticoagulation, acute kidney injury from antibiotics, heparin-induced thrombocytopenia, 2 – 4 some other iatrogenic incidents related to the staff, equipment, and facility (environment), which may include transport-related complications, electricity-related events, and medical gases-related events, and these are usually unexpected and require special skills in communication and management. 5 , 6 These complications may represent a major distress to the patient, caring medical team, and family members. Proper training, adequate preparation in anticipation of potential issues, and team work are the key and only way to handle these complications.…”