Immediate Actions |
- Activate ECMO Order Set (infants < 10 kg)
-
Call Blood Bank
- Alert to ECMO Cannulation x4-2527
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Consults/Contacts |
-
General Surgery Fellow/Attending
- Book case with the OR
- OR Team and equipment brought to bedside
- Sedation by Neonatology (Anesthesiology typically not present)
- Location: N/IICU bedside
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ECMO
- Notify PHL ECMO 1st Contact via Epic secure chat
-
Blood Bank
- Alert to ECMO Cannulation x4-2527
-
Cardiology
- Notify need for Echo to assess ECMO cannula position
- Weekdays: PHL Card Pulm Hyper IPM via Epic secure chat
- Evenings and weekends: PHL Card Cnslt 1st Contact via Epic secure chat
-
Brain Ultrasound
- Notify PHL Port US 1st Contact or call x5-7030 if not already done
-
Neurology
- Notify Neuro Cnslt NICU-CICU 1st Contact via Epic secure chat of formal consult
-
Video EEG
- Notify Neuro ICU EEG 1st Contact via Epic secure chat for video EEG placement after cannulation
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Labs, Imaging |
- Ensure the following have been obtained:
- PT, PTT, INR, Fibrinogen, AT3
- Newborn screen
- DNA extraction
- Blood culture, if indicated
- Brain ultrasound
- Echo: may defer postnatally if unstable and/or normal fetal Echo
- Type & Screen and Blood Type Confirmation
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Medications |
- Sedation and neuromuscular blocking agent to prevent air embolism:
- Fentanyl 10 mcg/kg/dose + 1-2 doses of 5 mcg/kg/dose
- Vecuronium 0.2 mg/kg/dose + 1-2 doses of 0.1 mg/kg/dose
- Perioperative prophylaxis:
- Regardless of scheduled antibiotics, administer cefazolin 30 mg/kg/dose prior to cannulation when surgeon present
- Note: Cefazolin not available in Pyxis
|
Nursing Preparation |
Prepare using N/IICU RN ECMO Cannulation Checklist
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