Introduction
In some clinical cases, the strain on a person’s body makes it especially difficult for heart and lungs to fulfill their respective roles. As a result, it becomes necessary to assist the patient’s body in oxygenating blood. For such situations, there is an existing procedure that removes carbon dioxide from blood, replacing it with oxygen. The process requires the use of specific medical machinery and is called Extracorporeal Membrane Oxygenation. There are many potential uses for this treatment. For example, a person on life support after a major surgery may require the use of ECMO to let their internal systems to recover properly. Alternatively, the procedure has found considerable popularity in treating severe COVID-19 cases.
Explanation and Background
As noted previously ECMO is a procedure designed to oxygenate a person’s blood. Typically, the process involves surgery, and is done in a patient’s room. First, a person is sedated and fed specific medication which dulls pain and makes the blood flow smooth. Then, special catheters are inserted into a patient’s veins/arteries. These catheters are connected to a pump, which will take blood from one’s body and transfer it into the lung-heart machine, responsible for oxygenation. Additional safety measures include supplemental nutrition and the use of ventilators, which assist a person’s lungs. The use of ECMO is effective in assisting people with a variety of heart and lung conditions. This includes heart attacks, inflammations, transplantation complications, ARDS, pneumonia and many others.
Risks and Benefits
Benefits
There are many potential benefits to using ECMO for patient treatment. As a whole, it helps one’s body to recover quicker, reducing the workload major organs have. After an organ transplantation, or a surgery, the use of ECMO ensures that no further procedural complications are encountered. In addition, this practice can be useful when a patient’s heart or lungs are unable to function properly, limiting the supply of oxygen into the body.
Complications
However, there are many potential risks in the process, most of which are connected with catheter use. A patient may experience excessive bleeding, brought on by the use of anti-clotting medication and the need to insert a catheter. In addition, infection is one of the major concerns, as places of catheter insertion may become dirty. When using ECMO, a patient is supplied with additional blood products in order to ensure their wellbeing. Blood transfusion used in the process can lead to health complications. When used on children, there is a considerable risk of developing seizures during ECMO. On the last vital note, oxygenation can put patients on a significant risk for having a stroke (Ezetendu et al., 2022). These problems offset the benefits of ECMO and make following procedural guidelines extremely important.
Preventing Complications
Possible dangers of bleeding and catheter injection, for example, are mitigated through nurse attention and sanitation measures. For other specific problems, solutions exist. The occurrence of seizures in children, is mitigated through the use of electroencephalogram which monitor brain activity (Hassumani et al., 2020). As suggested by studies, nurses play a central role in managing risk factors during ECMO, having a diverse range of responsibilities (Alshammari et al., 2020). Most complications connected with ECMO can be prevented through careful and attentive patient care.
Interdisciplinary Team’s Roles and Responsibilities
Team Members
According to present research, the use of interdisciplinary teams is vital to ensuring the success of an ECMO. In particular, issues can be found with the broad range of possible problems that are remedied through ECMO, each of which requires their own specialists. Therefore, the medical team responsible for administering ECMO should possess a diverse range of medical staff, ranging from physicians and nurses to engineers and respiratory therapists (Komindr et al., 2019). Only through the use of a well-coordinated multi-functional team is it possible to provide high standards of care.
Role of a Nurse
As mentioned previously, nurses play the most important role in ensuring the success of an ECMO. Their work ranges from delivering care to communication, making the many stages of the healthcare delivery process work together smoothly. Nurses are responsible for communicating with patient, learning about their potential allergies and reservations, alleviating the pressure of medical procedures from them. In a team effort, they are a connective tissue between all the other members, directing the flow of patient care to promote autonomy, wellness and recovery.
Challenges
One of the central challenges in using a diverse team comes from communication. When each professional is centered on their own task, it is vital that they are able to quickly and accurately exchange data between each other. Furthermore, the process of administering ECMO must be optimized to make it as quick as possible, as a contingency for preventing potential side effects.
Nursing Scope of Practice
Nurses should possess a variety of skill in order to work in an interdisciplinary team for administering ECMO. First, they must be proficient in inserting catheters, taking care of them, and disinfecting insertion points. This has to be done in order to both ensure a smooth ECMO and to limit potential infections. Furthermore, nurses should be capable of taking care of an unconscious patient for a prolonged amount of time, adjusting their position, providing nutrients and generally ensuring their wellbeing. For working in a team, nurses need excellent coordination and communication skills. First, they come into use when educating and instructing patients, then they are used in order to engage patients and healthcare delivery personnel into a shared discussion. Lastly, nurse communication helps other medical professionals to work on the process.
Patient Education
Patient education is needed to alleviate stress, promote autonomy and help people better understand the intricacies of the ECMO process. Nurses should be able to tell their clients about the ECMO procedure, its risks and benefits, as well as each of the steps involved in administering ECMO. After the treatment is complete, patients and their family must have a solid understanding of post-treatment care, especially regarding catheter wound treatment. All of the information should be delivered in a simple, informational manner, with the goal of informing the patients and helping them be calm. Any questions that might arise regarding the procedure should be explained, and the use of supplementary materials such as brochures is welcome.
Conclusion
In conclusion, ECMO is an important procedure in the healthcare delivery process. The use of blood oxygenation helps a person’s internal systems to better adjust to recent change, or combat disease. A coordinated delivery of care is necessary in order to limit possible complications and accomplish the goals of the procedure. Nurses, in particular, exist as a vital part of an interdisciplinary team, connecting all other specialists together and helping patients.
References
Alshammari, M. A., Vellolikalam, C., & Alfeeli, S. (2020). Nurses’ perception of their role in extracorporeal membrane oxygenation care: A qualitative assessment. Nursing in Critical Care, 27(2), 251-257.
Ezetendu, C., Baloglu, O., Othman, H. F., Nandakumar, V., Latifi, S., & Aly, H. (2022). Stroke in pediatric ECMO patients: Analysis of the national inpatient sample (NIS) database. Pediatric Research.
Hassumani, D., Mastropietro, C., & Friedman, M. (2020). 1: Children with cardiac disease on extracorporeal membrane oxygenation are at risk for seizures. Critical Care Medicine, 48(1), 1-1.
Komindr, A., Abe, R., Tateishi, Y., Takahashi, Y., Goto, J., Wada, K., Furukawa, Y., Sugiura, A., Imaeda, T., Suga, N., Hattori, N., & Oda, S. (2019). Establishing extracorporeal membrane oxygenation team increased number of patients and improved data recording. Journal of Intensive Care, 7(1).