Intensive Care NSW ECMO project

Extracorporeal membrane oxygenation (ECMO) is a modified heart-lung machine that provides lung and/or heart support in patients with extreme organ dysfunction refractory to conventional support strategies.

ECMO is a highly specialised service provided in specialist tertiary ICUs where clinicians with expertise in ECMO are available to support the initiation, ongoing management and post ECMO patient care.

Aim

To develop ECMO service models of care for adults and  neonate/paediatric ECMO retrieval for use by the NSW Ministry of Health, pillar organisations, Newborn and paediatric Emergency Transport Service (NETS), aeromedical retrieval services, NSW ambulance, speciality health networks (SHNs) and local health districts (LHDs)  to implement world class care for patients requiring ECMO retrieval.

Both models of care have been developed to support the following key principles of high-quality care:

  • support right care, right place, right time
  • maintain a strong workforce
  • communicate effectively
  • integrate system enablers

The information in the models of care are not a substitute for healthcare providers’ professional judgement. Specific information about the individual patient and consultation with other medical authorities must be considered as appropriate.

Benefits of ECMO service models of care

  • Promote early recognition and referral of patients to the NSW ECMO service
  • Provide criteria for patient selection
  • Provide advice for clinicians in the care of critically ill patients with severe respiratory and cardiac dysfunction where ECMO may be considered
  • Standardise the use of ECMO in the context of cardiopulmonary resuscitation
  • Support health practitioners in delivery of evidence-based care for patients requiring ECMO
  • Facilitate established retrieval pathways for those patients requiring inter-hospital transfer to an ECMO capable centre
  • Improve patient outcomes and experiences
  • Improve family member/carer experiences by providing clear communication and information throughout the patient’s hospital stay, particularly when patients are relocated away from where they live
  • Recommend minimum requirements for a sustainable ECMO service
  • Standardise an approach to clinician education, training and credentialing in ECMO delivery

Contact

Linda Williams
Network Manager, Intensive Care NSW
Phone: 0484 264 631
Email: linda.williams3@health.nsw.gov.au