Educational Corner Program 2020
Simulation-based learning is frequently used in medical education and skills training, especially related to complex technologies like extracorporeal systems.
Educational Corner during EuroELSO conference provides a near authentic experience and enhanced learning. EduCorner simulations rely on scenarios similar to clinical practice in controlled environment without any negative consequences of an error.
Repetitive practice leads to skill improvement with clearly defined goals. Lessons learned can be turned into effective improvements in the workplace and beneficial changes in how to cannulate and to manage patients on ECMO and ECLS.
Note: Registration for the Educational Corners is only possible for delegates of the EuroELSO Congress.
Overview
EC 1 I Ped ECLS basics troubleshooting
Trainers: Mirjana Cvetkovic, Maura O’Callaghan
Goals: This immersive hands-on workshop will employ the most up-to-date technology and techniques involving the clinical use of ECLS in pediatric patients.
Aims: Through clinical scenarios, we will apply the knowledge gained towards the troubleshooting of ECLS circuit utilizing high fidelity simulation lab in order to recognise ECLS complications.
1. Routine ECLS problems
– Access issues
– Flow fluctuations
– Kick-back of the venous line
– Bleeding cannula sites
2. Urgent and fatal ECLS problems
– Pump failure
– “Suck-down”
– Venous or arterial decannulation
– Cardiac arrest
Learning objective: Upon completion of this activity, participants should be able to recognize and identify:
– the components of the ECLS circuit;
– major indications and contraindications of VV and VA ECLS;
– address routine and catastrophic ECLS problems, patient- and ECLS circuit related problems.
EC 2 I ECLS Ped sim advanced
Trainers: Mirjana Cvetkovic, Maura O’Callaghan
Goals: Through clinical scenarios, learners will gain the knowledge about common, frequently occurring causes as well as rare, not so frequently occurring causes of desaturation on VV ECLS in pediatric patients.
Aims: We will apply the knowledge utilizing two scenarios using high fidelity simulation lab in addition to high quality feedback from experienced consultant trainers. Scenario 1: Desaturation on VV ECMO; Scenario 2: Management of pump failure on VA ECMO.
Learning objective: The participants will gain knowledge about troubleshooting fatal problems on ECLS circuit. The course has several aims in order to develop cognitive, psychomotor and behavioural skills and competences during ECLS high fidelity simulations.
EC 3 I Troubleshooting in VV-ECLS
Trainers: Hugo Guilliou, Raphaele Morfin, Chirine Mossadegh, Sacha Rozencwaig, Sabine Valera
Goals: Indications for extracorporeal pulmonary support, components of VV-ECLS cuircuit, troubleshooting.
Aims: Introduction to ECLS cuircuit and device, main emergency situations and their troubleshooting.
Learning objective: The participants will be able: to understand the indications for extracorporeal support, interaction between mechanical ventilation and extracorporeal gas exchange, to describe an ECLS circuit and explain the main parameters on ECLS device, to interven when facing the main adverse events encountered when managing the patient under VV-ECLS.
EC 4 I ECPR in OHCA
Trainers: Matthias Baumgärtel, Justyna Swol, Katrin Buttler, Katrin Emmrich, Steffen Nietzold, Domagoj Damjanovic
Goals: This workshop provides the insights how to perform cannulation via percutaneous vascular access during resuscitation of the arresting patient using mechanical circulatory support system in out-of-hospital cardiac arrest.
Aims: Step-by-step procedure of ECPR performance in out-of-hospital setting; ultrasound guided cannulation; equipment requirements; human factors and logistics.
Learning objective: We offer a training in advanced vascular access procedure to implement ECLS in order to cardiopulmonary resuscitation in out-of-hospital cardiac arrest (OHCA). Team logistics and all requirements of Extracorporeal Cardiopulmonary Resuscitation (ECPR) will be discussed.
EC 5 I Post-resuscitation care after ROSC by ECPR in adult
Trainers: Shingo Ichiba, Keiki Shimizu, Ichiro Takeuchi, Kensuke Fujita, Hiroyuki Tanaka
Goals: Monitoring and management for adult patients after ROSC and ECPR.
Aims: Targeted temperature management; cardio-pulmonary monitoring; management of differential hypoxia (Harlequine-Syndrome). Management of LV distension and it early prevention. Neurological monitoring, prognostication and ethical considerations.
Learning objective: The students will be able to explain what is the latest evidence of targeted temperature management after ROSC. They can explain how to monitor and manage cardiopulmonary condition as Harlequin syndrome and LV distension, and the usefulness of NIRS, rSO2 and/or aEEG monitoring. Students will understand ethical considerations for patients on ECLS in futile situation.
EC 6 I Ultrasound in ECLS cannulation and during the ECLS run
Trainers: Mateusz Puslecki, Marcin Ligowski, Sebastian Stefaniak, Bartlomiej Perek, Marek Dabrowski, Piotr Ziemak
Goals: Virtual reality simulation for ultrasound use and echocardiography (TTE and TEE) in ECMO cannulation and during the ECMO run.
Aims: Standardized simulation of ultrasound for peripherial and abdominal (e.g.VCI) vessels. Basic echocardigraphy (TTE and TEE) for ECMO.
Learning objective: Visualization of peripherial vessels for cannulation; use of abdominal ultrasound for confirmation of the wire during the cannulation; visualization of shunt during VA-ECLS; ultrasound techniques in monitoring during ECLS.
EC 7 I CRRT and plasma exchange on ECLS made easy
Trainers: Jo-anne Fowles, Margaret Farley, Rhea Durgahee
Goals: This workshop demonstrates the practice of managing the ECLS patient requiring haemofiltration (CRRT) and/or plasma exchange.
Aims: Management and troubleshooting of haemofiltration and/or plasma exchange during ECLS run. Identify differing methods of connecting haemofiltration (CRRT) and/or plasma exchange circuit to the ECLS circuit. Demonstrate connection and disconnection of haemofiltration and/or plasma exchange circuit to the ECLS circuit.
Learning objective: The participants will be able to explain the management of patient undergoing haemofiltration (CRRT) and/or plasma exchange circuit during ECLS, differing methods of connecting and risks associated with connection and disconnection of haemofiltration and/or plasma exchange circuit to ECLS circuit.
EC 8 I ECLS in cardiac arrest
Trainers: Alex Rosenberg, Brad Pates, Cindy Dutton, Matt Bell, Sagar Haval, Gary Notely
Goals: This workshop provides the insights to management of simulated cardiac arrest and all the necessary procedures required to start an ECLS in arresting patient. Participants are given a structured approach that they are welcome to use or modify in their own institutions with focus on team working, non technical skills and specific defined roles throughout the simulation.
Aims: High quality ALS provision occurs through out this high-fidelity simulation. The workshop offers the training – “how to do it”: – commence and manage a mechanical chest compression device, – criteria and candidates for ECPR, – necessary imaging to ensure the safest possible ECLS cannulation, – perform the cannulation; connect patient and ECLS device; – secure the cannulae; discuss the next management steps and outcomes.
Learning objective: The participants will learn how to work safely and effectively as a team to cannulate a patient and commence them on VA ECLS while continuing high quality advanced life support. A purpose built high fidelity mannequin is used to give a realistic experience of the procedure.
