Can simulation improve ECMO care?

“Bringing ECMO simulation to life”: The main theme of the 4th Annual Conference of the Extracorporeal Life Support Organisation – South and West Asia Chapter (ELSO-SWAC), “Bringing ECMO Simulation to Life”, is meant to emphasise the growing role of simulation in healthcare and medical education at large and in the highly specialised and complex field of extracorporeal life support (ECLS), and in particular for extracorporeal membrane oxygenation (ECMO). Application of ECMO simulation to improve team response to ECMO emergencies was first described in 2006. 1 In the last decade, several authors have described the development, utility, and advantages of simulation-based training for ECMO. In this editorial, we will discuss the role of and evidence supporting the use of simulation-based education in ECMO. ECMO is a complex intervention: The first point to consider when it comes to ECMO is the complexity, time critical, and inter-disciplinary nature of the intervention. Typically, ECMO is considered for the most sick and physiologically deranged patient, sometimes as a last resort rescue measure. Time pressure, the patient critical condition, the potential rapid deterioration, and the uncertainty interact within the critical care environment to make decision-making, planning, and execution quite challenging for the less experienced members of the clinical team. This relates to the domains of team and crisis resource management in which there is a complex interplay of human and environmental factors involved. 2 Appropriate training programmes of the required technical and non-technical skills for ECMO are lacking. 3,4 In addition, ECMO is relatively new to many centres and/or countries, and this novelty brings with it a general lack of experience regarding such therapy and the fear of the unknown. Simulation can help relieve staff anxiety and introduce ECMO in a safe, less intimidating learning environment. 3,4 Ideally, all aspects of ECMO patient care can be progressively introduced to the staff being trained through the use of various simulation modalities to promote better understanding and deep learning regarding the initiation of an ECMO run and ongoing ECMO patient care.


Read More: http://www.qscience.com/doi/abs/10.5339/qmj.2017.swacelso.7