oa ECMO nursing training: UAE experience

Extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) is a highly specialized procedure relying on advanced technology, and specific attention is required to ensure safe operation. Who should or can accomplish this procedure is roughly defined by the ELSO guidelines.¹ Before starting an ECMO program, proper assessment of resource adequacy is crucial, and developing the structure for the program is mandatory. Recommendations can be found on the Extracorporeal Life Support Organization (ELSO) website.² Formal training of the whole team is desired, not to say highly recommended, to be able to provide the best patient care possible.

In the UAE, the need for an ECMO program was identified and formalized in 2009. Two batches of nurses were consequently sent to a high-volume ECMO center in Europe to acquire both theoretical knowledge and practical training in the waterlab to master the required technical skills. Observation of clinical shifts and daily routine for ECMO as well as sharing protocols and policies provided for a safe startup in the UAE. When volume increased and the need for more trained nursing specialists was identified, we developed a three-day specific training course: first day for general introduction, second day for veno-arterial (VA) ECMO, and third day dedicated to veno-venous (VV) ECMO. The course is backed by competency assessment during supervised bedside shifts.

Maintenance of task skills for our ECMO team is achieved during monthly waterlab sessions (de-airing, pump failure, etc.) when not only manual practice is done, but also case presentations and reviews are discussed, team debriefing is done, and lectures are delivered to ensure up-to-date knowledge and understanding. The importance of simulation for ECMO has been described,³ and we made it a focus of our specialist ECMO training. Our concept of training has since then spread over the Middle East area and South Africa.