CES ECMO Team Roles & Communication 1 — Questions and Answers
Question 1: Who has primary responsibility for ECMO circuit management during a patient transport?
- The transport nurse
- The bedside ICU nurse
- The ECMO specialist (perfusionist or trained clinician) accompanying the patient (Correct answer)
- The receiving facility's intensivist
Correct answer: The ECMO specialist (perfusionist or trained clinician) accompanying the patient
The ECMO specialist is responsible for circuit management, troubleshooting, and safety during patient transport.
Question 2: Which team member typically leads the ECMO cannulation procedure in most US ECMO centers?
- Critical care intensivist
- Cardiothoracic or vascular surgeon (Correct answer)
- Bedside ECMO nurse
- Perfusionist
Correct answer: Cardiothoracic or vascular surgeon
Cardiothoracic or vascular surgeons most commonly lead cannulation at US centers, though practices vary by institution.
Question 3: The ECMO specialist's primary role includes all of the following EXCEPT:
- Monitoring circuit pressures and flow
- Managing anticoagulation in collaboration with the physician
- Adjusting ventilator settings independently without physician order (Correct answer)
- Troubleshooting alarms and circuit issues
Correct answer: Adjusting ventilator settings independently without physician order
Ventilator management requires physician orders; ECMO specialists manage circuit function but do not independently adjust ventilator settings.
Question 4: During a code blue on an ECMO patient, the ECMO specialist's priority is:
- Initiating compressions
- Managing circuit flow and communicating ECMO parameters to the resuscitation team (Correct answer)
- Administering medications
- Documenting the resuscitation
Correct answer: Managing circuit flow and communicating ECMO parameters to the resuscitation team
The ECMO specialist's role in a code is to optimize circuit support, manage flow adjustments, and communicate ECMO status to the team conducting the resuscitation.
Question 5: Structured ECMO handoff communication (SBAR) should include which ECMO-specific element?
- Current circuit flow, pressures, sweep gas settings, anticoagulation status, and recent alarms (Correct answer)
- Patient demographics and insurance information
- Nursing shift assignments only
- Dietary preferences and family visitation schedule
Correct answer: Current circuit flow, pressures, sweep gas settings, anticoagulation status, and recent alarms
ECMO-specific SBAR handoff must include flow, pressure parameters, sweep gas, anticoagulation status, and any recent alarms or interventions.
Question 6: Which organization provides the primary credentialing framework and competency standards for ECMO specialists in the US?
- AARC (American Association for Respiratory Care)
- ELSO (Extracorporeal Life Support Organization) (Correct answer)
- AABB (American Association of Blood Banks)
- ABIM (American Board of Internal Medicine)
Correct answer: ELSO (Extracorporeal Life Support Organization)
ELSO provides international ECMO guidelines, training standards, and the primary registry for outcomes that support ECMO specialist competency frameworks.
CES ECMO Team Roles & Communication 1
Who has primary responsibility for ECMO circuit management during a patient transport?