HCSS Extracorporeal Membrane Oxygenation (ECMO) specialist/Perfusionist

HCSS Extracorporeal Membrane Oxygenation (ECMO) specialist/Perfusionist Texas, United States Hot 2 additional locations Galveston, Texas, United StatesUnited States Nursing & Care Management HealthCare System Staffing Requisition # 2505153

JOB SUMMARY

The ECMO Specialist (ES) is a licensed allied health care professional with a strong clinical background in neonatal, pediatric and/or adult critical care and advanced cardiopulmonary support. The ES has ≥ 2 years ICU experience or completion of an accredited cardiovascular perfusion training program. The ES is responsible for the coordination of clinical care for patients requiring the support of extracorporeal life support (ECLS) & mechanical circulatory support (MCS) devices under the direction & supervision of credentialed ECMO and advanced heart failure physicians. The ES adheres to the policies, guidelines & best practices set forth by the director, manager & coordinator of the ECMO department. The ES plays a key role in device management, patient monitoring, emergency response, and quality improvement initiatives. Clinical Level Detail The ECMO Specialist (ES) is a competent technical specialist, preceptor & ECMO primer. The ES is a proficient clinician in two high acuity clinical environments where care of an ECLS or MCS patient is provided (2 ICU's or Any ICU + OR, CVL, Transport etc.) & in two patient populations (Adult, Pediatric &/or Neonatal). Clinical Level Minimal Experience The required experience to qualify as an ES is ≥ 2 years’ experience as an ES; or completion of an accredited program in cardiovascular perfusion, nursing, or respiratory therapy. Completed annual required hands-on drills, simulations & passed annual competency examination(s) for an ES. Completed clinical ECMO orientations in two patient populations (Adult, Pediatric &/or Neonatal). Clinical Level Responsibilities The ES is trained to independently prime, operate, troubleshoot & manage ECLS & MCS devices. The ES can independently initiate support & manage advanced ECLS & MCS care plans. The ES can independently troubleshoot clinical scenarios. The ES is trained to independently manage ECLS & MCS emergencies and coordinate the allied health care team to implement major interventions. The ES is a clinical preceptor and resource for level I & II specialists.

MAJOR DUTIES / CRITICAL TASKS

Programmatic Responsibilities Education : Collaborates with ECMO team leadership and contributes to education, training, precepting & mentoring of all ES I & II team members. Equipment : Assists leadership with equipment maintenance, cleaning & troubleshooting of ECMO, MCS & ECMO monitoring equipment. Ensures backup ECMO circuit is primed & ready for use each shift. Technical Specialist Responsibilities Patient Identification : Collaborates with multidisciplinary physician teams to identify patients indicated for ECLS or MCS therapies and in concordance with ECMO physician guides care team to adhere to indications and contraindications as found in program guidelines and policies. Initiation of Support : Coordinates & collaborates with multidisciplinary care team to prepare patient and environment for the timely and safe initiation of ECLS or MCS support. Patient Management & Monitoring on Support : Assess and manage patient clinical needs, including but not limited to patient assessment, hemodynamic monitoring, NIRS, blood gas interpretation, laboratory results, fluid balance, nutrition, respiratory support, neurologic status, infection control, sedation, pain management, hematology, and cardiac function. Documentation : In collaboration with bedside clinician, follows department guidelines for EMR documentation. Utilizes the ECMO flow sheet & EMR to maintain ongoing detailed documentation of the ECMO case. Diagnostic Testing : Coordinates with care team to ensure safe execution and delivery of diagnostic testing such as x-ray, ultrasound, echocardiography, EEG including safe and timely transportation to CT, invasive lab or operating room. Evaluates chest x-rays for endotracheal tube, ECMO cannula, or MCS device position and placement. Extracorporeal VAD Management : Assist the physician during insertion of extracorporeal VAD devices; manage and troubleshoot equipment issues such as pump failures or circuit occlusions; monitor and optimize patient hemodynamics and anticoagulation strategies to prevent thrombosis or bleeding; coordinate discontinuation and removal processes. Percutaneously Inserted VAD Management : Assist the physician during percutaneous insertion; manage and troubleshoot device-specific issues like position migration or suction events; assess patient hemodynamics and anticoagulation protocols; oversee discontinuation, including safe removal and post-removal monitoring. Implanted VAD Management : Assist the physician & VAD coordinator during surgical implantation; manage and troubleshoot equipment such as driveline issues or pump thrombosis; evaluate and fine-tune patient hemodynamics and long-term anticoagulation strategies; facilitate discontinuation through explanation or transition to other therapies. ECLS Circuit Priming and Initiation : Prepare and prime ECLS circuits, ensuring sterility and functionality prior to patient connection. ECLS Circuit Blood Priming : Safely blood primes ECMO circuits for patients as indicated by department guidelines and policies. ECMO Circuit Maintenance : Continuously monitor and maintain ECMO circuit integrity, adjusting blood flow rates and monitoring pressure gradients to prevent complications. ECMO Circuit Evaluation : Use in-line tools and blood gas analyses to calculate metrics such as oxygen consumption, oxygen delivery, and recirculation. ECMO Circuit Troubleshooting : Identify and resolve issues such as circuit leaks, component failures, or suboptimal performance. Anticoagulation Management on ECMO : Monitor and adjust anticoagulation levels to balance thrombosis and hemostasis risks. Clot Formation Management : Evaluate clot formation and recommend anticoagulation adjustments. CVVHD/Hemodialysis Management : Assist in setup of continuous veno-venous hemodiafiltration or hemodialysis devices integrated into the ECMO circuit; monitor therapy parameters and troubleshoot issues. ECMO Circuit Ultrafiltration Techniques : Implement ultrafiltration strategies within the ECMO circuit; monitor fluid input and output. Cytokine and Inflammatory Marker Removal : Insert cytokine absorbers into the ECMO circuit for removal of cytokines and endotoxins. Medication Administration to ECMO Circuit : Administer medications directly into the ECMO circuit as directed by the physician. Blood Product Administration to ECMO Circuit : Administer blood products via the ECMO circuit to maintain target hematologic parameters. ECMO Circuit Flow Management : Manage all ECMO circuit flows, interpreting pressure changes and communicating concerns with the physician. Troubleshooting ECMO System Alarms : Interpret and troubleshoot ECMO system alarms, triaging the need for interventions. Troubleshooting Ancillary Equipment Functionality & Alarms : Address alarms from ancillary equipment, coordinating replacements as required. ECMO Transport : Safely lead and coordinate inter-facility and intra-facility ECMO transport. Weaning, Withdrawal & Decannulation from ECMO : Assess patient readiness for weaning and coordinate safe transition off ECMO. Emergency Responses The ECMO Specialist will master the necessary skills with repeated clinical drills until meeting the ECMO director, manager, and/or coordinators’ expected time and best practice goals in response to ECMO emergencies. Emergency response training includes, but not limited to: Power failure : Ensure equipment is connected to generator backed red outlet and backup equipment is available. Equipment Failure & Hand Cranking : Triage the need for emergency hand cranking, coordinating with the allied health care team to start emergency ventilation & patient management strategies. Blood Pump Failures : Rapidly triage and differentiate blood pump failures and replace failed pump. Air Entrainment : Detect and eliminate air bubbles using de-airing techniques and clamp the circuit. Cannula Dislodgement : Clamp dislodged cannula and coordinate with the care team for immediate surgical intervention. Cannula Malpositioning or Impedance of Flow : Reposition or exchange cannula to re-establish flow. Uncontrolled Hemorrhage : Manage acute bleeding by administering fluids or blood products and stopping anticoagulation. Advanced Life Support (ACLS, PALS, BLS) : Collaborate with multidisciplinary team to stabilize hemodynamics of the patient and adjust ACLS & PALS algorithms. Circuit Exchange : Coordinate safe full circuit exchange if indicated. Circuit Tubing or Component Fracture, Rupture or Failure : Replace tubing or component and restore circuit integrity. Circuit Obstruction of Flow : Detect and correct obstruction of flow by evaluating pressures and visually inspecting for kinks. Oxygenator Failure : Monitor blood flow and gas exchange metrics, triage for immediate replacement, and coordinate oxygenator change-out procedure.

KNOWLEDGE/SKILLS/ABILITIES

Satisfactory maintenance of clinical competencies: Attendance to quarterly water drills. Satisfactory completion of the annual ECMO didactic program, satisfactory score of 90% and above on annual ECMO exam. Satisfactory completion of required special procedure classes (e.g., blood administration). Knowledge regarding quality improvement and standards of care within practice area. Experience teaching patients and families. Excellent communication skills. Knowledge of and ability to evaluate and assess arterial blood gas measurements. Ability to respond to emergent or stressful situations appropriately, calmly, and in a timely manner. Will respond to ECMO activation within 45-60 minutes.

REQUIRED EDUCATION / EXPERIENCE

Licensed as Certified Clinical Perfusionist (CCP) as recognized by the American Board of Cardiovascular Perfusion (ABCP) and State of Texas Licensure as a Licensed Perfusionist. Graduate of Perfusion Program Preferred Baccalaureate degree and certification in care specific area. Two (2) years directly related critical care experience in adult or neonatal and/or pediatric care including patient assessment, technical skills, and psychosocial aspects of care. Must have current BLS obtained through American Heart Association (AHA).

WORKING ENVIRONMENT/EQUIPMENT

May be required to travel in ambulance with patient. Ability to lift up to 50 pounds maximum with frequent lifting/and or carrying objects. Compensation Hiring Range: $100.00 #J-18808-Ljbffr UTMB Health