The extracorporeal membrane oxygenation (ECMO) team from Pediatrix Critical Care of California at Sutter Medical Center in Sacramento was recently awarded the Platinum Excellence in Life Support Award from the Extracorporeal Life Support Organization (ELSO).
The company’s highest award, the ELSO Excellence in Life Support Award acknowledges programs worldwide for their exceptional commitment to excellence and superior ECMO care, achieved through distinct training, processes, procedures and systems.
What is ECMO?
ECMO is a complex and invasive procedure that involves removing blood from the body, oxygenating it outside the body and then returning it. A patient in the pediatric intensive care unit (PICU) may need ECMO therapy for various reasons, typically when their heart or lungs are severely compromised and conventional treatments are not sufficient. ECMO provides temporary life support by taking over the function of these vital organs, allowing them to rest and recover. Several situations where ECMO may be used in a PICU include:
- Severe respiratory failure — When a child’s lungs cannot provide enough oxygen or remove carbon dioxide from the blood, ECMO can assist with oxygenation and carbon dioxide removal.
- Cardiac support — In cases of severe heart failure or after certain cardiac surgeries, ECMO can help pump oxygenated blood throughout the body while the heart heals and recovers.
- Post-cardiac arrest — After a cardiac arrest, ECMO can provide circulatory support to improve the chances of the child’s heart recovering its normal function.
- Pulmonary hypertension — Some children with severe pulmonary hypertension may require ECMO to maintain proper oxygen levels in their blood.
- Meconium aspiration syndrome — Newborns with meconium aspiration, a condition where they inhale their first stool, might require ECMO if their lungs are severely affected.
- Congenital heart defects — In some cases, infants born with complex congenital heart defects may need ECMO as a bridge to surgery or while awaiting heart transplantation.
“ECMO in the PICU is not just a machine; it’s a lifeline,” said Daniel Falco, M.D., a pediatric intensivist and practice medical director at Pediatrix Critical Care of California. “It gives us the ability to support the sickest hearts and the most fragile lungs, offering hope where there was little. In our pursuit of saving lives, ECMO is a remarkable tool, bridging the gap between critical illness and recovery, reminding us that miracles can happen in the most challenging moments.”
Dedicated Team of ECMO Experts
Due to the critical nature of ECMO therapy and the potential risks, it’s essential for ECMO professionals to possess the specialized knowledge and skills necessary to provide optimal care to patients requiring ECMO support. There are several aspects of ECMO training, such as:
- Certification programs — ECMO specialists typically undergo specialized training programs and certification through specific organizations and institutions.
- Clinical experience — Health care professionals, such as pediatric intensivists, critical care nurses, perfusionists, cardiac surgeons and respiratory therapists, gain hands-on experience in ECMO management under the guidance of experienced ECMO specialists.
- Simulation training — Simulation training allows health care professionals to practice ECMO procedures in a controlled environment, improving their skills and response to various scenarios.
- Team training — ECMO is often administered by a multidisciplinary team, so effective communication and teamwork are crucial.
- Ongoing education — Because ECMO technology and protocols continue to evolve, ECMO professionals must stay updated with the latest developments through ongoing education and training.
- Maintenance of certification — Many ECMO specialists are required to maintain the certification through regular reevaluation and continuing education to ensure they meet current standards of care.
Debra Davey, M.D., a pediatric intensivist and director of the PICU’s ECMO program, Dr. Falco and the PICU team works seamlessly together to provide ECMO therapy to children facing life-threatening conditions. Their level of expertise and collaboration affords children entrusted to their care the ability to recuperate.
“Our team carefully assesses each patient’s condition, initiates ECMO when necessary and monitors the child’s progress around the clock,” said Dr. Davey. “Our multidisciplinary team approach is vital to patient outcomes because it combines the expertise of various medical professionals, ensuring comprehensive care that addresses both the technical and holistic needs of our patients.”
Supporting Parents and Families
The need for ECMO treatment, while beneficial to patients, takes a toll on their loved ones. To say it’s a stressful, challenging time for parents and families whose child requires ECMO therapy is an understatement. ECMO is typically used as a last resort to save a child’s life when other treatments have failed.
While the patient is always the top priority, their loved ones should also be treated with compassion. A seasoned ECMO team collaborates with family members to help educate them on their child’s condition and their care plan, provide emotional support to help lessen their stress and anxiety and communicate regularly so they never feel like they are left in the dark and helpless.
“Our expertise extends beyond the technical aspects of ECMO, encompassing the emotional support and communication required for the child’s family,” said Dr. Falco. “By addressing the emotional needs of parents and family members with sensitivity support, we can help them navigate the difficult journey of having a child on ECMO and promote their emotional well-being during this trying time.”
Medical Professionals Nurturing Their Own
Medical professionals in the PICU are also often faced with incredibly challenging and emotionally taxing situations. Their daily responsibilities involve caring for critically ill children, witnessing the anguish of families and making life-and-death decisions. While they dedicate their lives to saving lives, losing a child facing a life-threatening illness or injury is inevitable.
In this incredibly intense environment, the need for emotional support among medical professionals becomes a pillar of strength, fostering camaraderie, empathy and resilience in the face of the emotional challenges they encounter daily.
“It’s vital that we take care of each other and have mechanisms in place to help with that, such as our friendship and camaraderie over the years,” said Dr. Falco. “We have a chaplain who works with us to do debriefs after a patient succumbs to his or her illness, we have a palliative care doctor who works with us in various ways on individual and group levels. All of these measures help us process devastating situations and provide a safe space to express our feelings and find renewed motivation.”
Earning Platinum
Earning the platinum award is a strenuous process that involves demonstrating that the PICU team consistently excels in seven categories — patient and family focus, workforce focus, knowledge management, quality focus, process optimization, systems focus and environmental focus. In addition, the team must demonstrate extraordinary achievement in three areas as part of the award application, including:
- Excellence in promoting the mission, activities and vision of ELSO
- Excellence in patient care by using the highest quality measures, processes and structures based on evidence
- Excellence in training, education, collaboration and communication, supporting ELSO guidelines that contribute to a healing environment for families, patients and staff
They must also be an active ELSO member in good standing and report all patients treated with ECMO therapy to ELSO.
“As all of our Pediatrix ECMO teams nationwide strive for platinum status with ELSO, we must remember that it’s not just about machines and protocols,” said Dr. Davey. “It’s about the unwavering commitment to each child’s life and the tireless collaboration of a dedicated team that defines our success in the PICU.”
Visit our website to learn more about Pediatrix pediatric intensive care unit services.