Authors (including presenting author) :
Yim CH(1), Wan HYS(1), Fung SH(1), Wong LY(1)
Affiliation :
(1)Department of Cardiothoracic Surgery, Queen Mary Hospital
Introduction :
ECMO is a form of mechanical circulatory support that enables both systemic perfusion and gas exchange, and is used in situations of acute circulatory and /or pulmonary failure. The Department of Cardiothoracic Surgery at Queen Mary Hospital provides 24-hour adult and pediatric ECMO service, and is the largest single provider of such service in Hong Kong. As a result of increasing and widening indications for ECMO, where the need for instituting eCPR and ECMO retrieval were extremely urgent and where a prompt response in choosing appropriate Arterial and Venous cannula size became a key factor in the outcome for the patient. This could be more of a challenge for nurses who have not familiar with ECMO cannula. This is the reason why we proposed to provide an ECMO cannulation guideline for all nurses to assist rapid initiation of ECMO when necessary.
Objectives :
To provide a cannula size guide for nursing staff to determine and prepare the cannula quickly and appropriately when rapid eCPR is needed.
Methodology :
This study was governed by cardiothoracic surgeons and perfusionists. We analysed all ECMO records between 2016 and 2018. The sizes of both arterial and venous cannula used, types of cannula, types of cannulation and body weight of the patient were studied. A table of recommended cannula size guideline is tailored made for references. Colour coding is used to distinguish the arterial (Red), venous (Blue) and double lumen cannulae (Yellow) whereas the location of cannula is stated. Post questionnaire was sent to nurses to collect the feedback about the table.
Result & Outcome :
A table of general guidelines for eCPR cannulation is provided. The sort recommended cannula is classified in to different cannulation sites and the size is given according to body weight. The feedback from nurses was clear, easy to find the cannula needed. The time required to prepare optimal cannula is shorten from 5 minutes to 1 minute. This cannula size guideline enhanced the efficiency of emergency services by enabling every nurse to assist during the critical situation. Future audit would confirm the efficiency of this guideline.
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