tailieunhanh - Ebook Nursing care and ECMO: Part 2

(BQ) Part 2 book “Nursing care and ECMO” has contents: Monitoring the ECMO, transport under ECMO, weaning process from venoarterial ECMO, initial training of nurses, weaning of venovenous extracorporeal membrane oxygenation, and other contents. | Chapter 5 Monitoring the ECMO Chirine Mossadegh As we saw in the previous chapter, the ECMO device is complex and requires a precise, thorough, and constant management. The aim of this chapter is to describe and explain the different aspects of managing ECMO patients at bedside after implantation. We will be discussing here only about centrifugal pumps. The monitoring of an ECMO patient starts first like the surveillance of any ICU patient starting with a head-to-toe assessment of the patient: • Vital signs: heart rate, mean arterial blood pressure (MAP), temperature, saturation, central venous pressure (CVP) • Physical assessment noting: hypoperfusion signs, sweating, moisture level • Neurological status: consciousness, pupillary reaction • Check of all the devices: IV lines, dressings, ventilator, infusion pumps In addition to these regular rounds will be added the monitoring of the ECMO device itself and the surveillance of all the potential risks linked to the ECMO.   Monitoring the Circuit   The Circuit Check It is a complete check up of the ECMO: plugs, fluid connectors, alarms, the integrity of the whole circuit: C. Mossadegh Critical Care Department, Cardiology Institute, Groupe Hospitalier Pitié Salpétrière, 47, Boulevard de l’hôpital, 756513 Paris cedex 13, France e-mail: cmossadegh@ © Springer International Publishing Switzerland 2017 C. Mossadegh, A. Combes (eds.), Nursing Care and ECMO, DOI 45 46 C. Mossadegh • The position of the device: The ECMO cart should be placed on brake position, with the controller facing the entrance of the patient’s room. It allows any caregiver to have a visual on the parameters immediately as he enters the room. • Power supply: Check that the ECMO is correctly plugged, if possible, to a secure plug (a red power outlet). Every ECMO device, whatever the brand, has a power and a battery light on the controller; make sure the battery light is off and the power light is .