Circuit And Equipment

Arora, Lovkesh1; Jawara, Dawda2; Evans, Erin1; Przybylski, Erick2; McCarthy, Dan2

1University of Iowa, Iowa City, USA.

2University of Wisconsin, Madison, USA

Background: Venoarterial extracorporeal membrane oxygenation (VA ECMO) is an emergency procedure performed across various specialties. These conditions present barriers to education and assessment of competency. Checklists and simulation may be useful supplements to cannulation training. The objective of this study was to develop a checklist for VA ECMO cannulation and assess performance using a novel high-fidelity cannulation simulator.

Methods: Using a modified Delphi technique, six experienced cannulators created a femoral VA ECMO cannulation checklist. In a video monitored setting, fellows and attending physicians underwent a simulation training at two academic institutions in Wisconsin and Iowa. Cannulation videos were scored on a 23-item checklist with a maximum of 34 points. Pre- and post-cannulation surveys were completed by the participants.

Results: The simulation was completed by 10 participants. The mean and median scores of the participants were 31.8 (SD 2.2) and 32.5 (IQR 1.8), respectively. The most commonly missed items on the checklist was related to wire confirmation in the vessels. Additionally, 75% of the participants felt the simulator provided a “suitably realistic experience with cannulation”.

Conclusions: The cannulation checklist and simulator resulted in reproducible performance assessments and consistently positive participant feedback, suggesting these tools may be a useful addition to a cannulation curriculum. Performance assessments can be used to improve training curricula and to document proficiency prior to independent practice. Further research is necessary to validate whether this tool can discriminate between experienced and novice operators.