The World Health Organization has launched a free open access course, the WHO Critical Care Training Short Course for Severe Acute Respiratory Infection (SARI), including content on clinical management of patients with a severe acute respiratory infection, intended for clinicians working in ICUs in low and middle-income countries involved in critical care management of adult and pediatric patients with severe forms of SARI, including severe pneumonia, ARDS, sepsis and septic shock, during outbreaks of influenza virus (seasonal) human infection due avian influenza virus (H5N1, H7N9), MERS-CoV, nCoV or other emerging respiratory viral epidemics. Visit OpenWHO to enrol and take the course. Here a list of the topics covered by the course: introduction to the 2019–nCoV and infection prevention for patients with Severe Acute Respiratory Infections (SARI); clinical syndromes and pathophysiology of sepsis and ARDS; triage and early recognition of patients with SARI, with role-playing scenarios; monitoring patients with SARI; differential diagnosis, specimen collection and diagnostic tests for SARI; oxygen Therapy; antimicrobial therapy and its modification after diagnostic test interpretation; how to deliver targeted resuscitation for sepsis and septic shock; mechanical ventilation: how to deliver lung-protective MV in ARDS; sedation: how to manage pain, agitation and delirium; best practices to prevent complications; weaning from mechanical ventilation; quality in critical care; pandemic preparedness and ethical considerations.
Need to improve your cannulation skills?? Want to act faster & safer next time you need to implement extracorporeal support? Join the ELSO Cannulation Workshop! This focused course, taught by a ELSO ECMOed Education Committee using realistic cannulation models, will train physicians to safely perform percutaneous #ECLS cannulation. All attendees will learn all aspects of cannulation in a small-group hands-on format; specific content includes: equipment selection, #POCUS vessel assessment, #ultrasound-guided vascular access, serial dilation, catheter placement and securement. Instructors will emphasize the value of imaging & address complication troubleshooting. At the conclusion of the course participants will be prepared to perform percutaneous veno-venous, veno-arterial, and bi-caval ECMO cannulations at their institution. Save the date! September 21st or 22nd, 2020 Hilton Waikoloa Village Big Island of Hawai’i… Registration opening soon!!& do not forget, same venue, following the workshop, #ELSO2020 the 31st Annual ELSO – Extracorporeal Life Support Organization Conference: a special event at a special place, September 23-26, 2020! https://www.elso.org/Education/2020Hawaii.aspx
Global ECMO education & agenda for the future: read the ELSO ECMOed Taskforce position paper on Critical Care Medicine at http://bit.ly/ECMOedpospaper & prepare your questions/comments! a dedicated twitter chat under the hashtag #ECMOedPP will be held on Jan 9 2020, with all the ECMOed Workgroups representatives and members! at 9.00 -10.00 pm CST 10.00 – 11.00 pm EST 7.00 – 8.00 pm PST 4.00 – 5.00 am CET/3.00 – 4.00 am UTC/GMT (Jan 10) 2.00 – 3.00 pm AEDT (Jan 10) etc…
Are you inexperienced with twitter & twitter chats?? in the picture some advices… do not forget to mention ELSO @ECMOed & add the official hashtag #ECMOedPP in all your replies, questions, comments!!
First authors Bishoy Zakhary @bishoy_zakhary & Kiran Shekar @kshekar01 Chat moderator Velia Antonini @foamecmo Critical Care Medicine twitter account @CritCareMed
Here twitter handles of ECMOed members (alphabetical order!) Ait Hssain: @AiHssain Assad Sassine: @Assad_sassine Bishoy Zakhary: @bishoy_zakhary Cara Agerstrand: @caraagerstrand Elizabeth A. Moore: @MooreElizabethA Grace Bichara: @gracebichara Guillaume Alinier: @g_alinier Ibrahim Fawzy Hassan: @IbrahimFawzyHa1 Jae-Seung JUNG: @JaeSeungJUNG1 Jayne Sheldrake: @jaynesheldrake Jenelle Badulak: @jenellebadulak Jeannie Kukutschka @jkukutschka Jose Alfonso Rubio: @joseAlfonsrubio Kiran Shekar: @kshekar01 KR Ramanathan: @KrKrramanathan Leen Vercaemst: @VercaemstLeen Leonardo Salazar: @demotucordis Lindsay Johnston: @lincjohnston Mark Davidson: @MarkGlasgowPICU Mark Ogino: @OginoMark Peter Roeleveld: @pproeleveld Simon Finney: @Simon_Finney Velia Antonini: @FOAMecmo Vitor Barzilai: @barzilaivs Wallace Ngai: @wallacengai
Fist obliged citation: the ECMOed Taskforce position paper, to describe the state of ECMO education worldwide, noting current limitations and challenges, & to put forth an educational agenda regarding opportunities for an international collaborative approach toward standardization.
Zakhary B, Shekar K, Diaz R, Badulak J, Johnston L, Roeleveld PP, Alinier G, Lai PCK, Ramanathan K, Moore E, Hassan I, Agerstrand C, Ngai WC, Salazar L, Raman L, Bembea MM, Davidson M, Gomez-Gutierrez RD, Mateo-Sidrón JAR, Kukutschka J, Antonini MV, Dickstein ML, Schmidt M, Abrams D, Ogino MT; ELSO ECMOed Taskforce.Position Paper on Global Extracorporeal Membrane Oxygenation Education and Educational Agenda for the Future: A Statement From the Extracorporeal Life Support Organization ECMOed Taskforce. Crit Care Med. 2019 Dec 11. link
ECMO education, in particular with regards to emergencies during a veno-arterial ECLS run, is challenging due to its intrinsic characteristics: a complex, high risk, often relatively low volume activity requiring dynamic decision making, multidisciplinary teamwork & communication, and rapid response. A simulation training focusing on CRM – Crisis Resource management and interprofessional communication could effectively address these educational needs. Institutional commitment to provide resources (both capital & human) is mandatory to the success of ECMO training programs. Read this full open access paper, Wallace Ngai of the ECMOed Workshops WG & Peter Lai of the Curriculum WG named among authors, congratulations!
Sin SWC, Ng PY, Ngai WCW, Lai PCK, Mok AYT, Chan RWK. Simulation training for crises during venoarterial extracorporeal membrane oxygenation. J Thorac Dis. 2019 May; 11(5): 2144–2152. open access link
ECMO simulation-based training: a safe venue to practice complex interventions & learn how troubleshooting at best ECLS related complications through a well-coordinated teamwork. In this paper, Professor Guillaume Alinier, member of the ECMOed Curriculum & Research workgroups, and his colleagues of Qatar University & Hamad Medical Corporation in Doha, propose a novel SBT solution not based on real ECMO equipment but trying recreating problematic situations & emergencies scenarios with realism/high-fidelity and remote control, while avoiding costs related to extracorporeal support machine/circuits, enjoy!
Al Disi M, Alsalemi A, Alhomsi Y, Bensaali F, Amira A, Alinier G. Extracorporeal membrane oxygenation simulation-based training: methods, drawbacks and a novel solution. Perfusion. 2019 Apr;34(3):183-194. link
Screen-based simulators as affordable & realistic alternative to replace conventional ECLS education?? Here, an evaluation of the efficacy of an open-source interactive & low-cost screen-based ECMO simulator, showing no significant dissimilarities between training through this simulator and didactic classroom-based teaching, in terms of learning outcomes, self-efficacy, learner performance (& both could be considered complementary to mannequin-based immersive #simulation training). ECMOed members Mark Ogino, President of the ELSO, and Guillaume Alinier cited between the authors.
Alsalemi A, Tanaka L, Ogino M, Disi MA, Alhomsi Y, Bensaali F, Amira A, Alinier G. A skills acquisition study on ECMOjo: a screen-based simulator for extracorporeal membrane oxygenation. Perfusion. 2019 Jul 13:267659119859120. link
A mandatory reading, with referral to standardization: another ELSO position paper, a consensus about nomenclature & abbreviations for extracorporeal life support to ensure accurate, concise communication.
Broman LM, Taccone FS, Lorusso R, Malfertheiner MV, Pappalardo F, Di Nardo M, Belliato M, Bembea MM, Barbaro RP, Diaz R, Grazioli L, Pellegrino V, Mendonca MH, Brodie D1, Fan E, Bartlett RH, McMullan MM, Conrad SA. The ELSO Maastricht Treaty for ECLS Nomenclature: abbreviations for cannulation configuration in extracorporeal life support – a position paper of the Extracorporeal Life Support Organization. Crit Care. 2019 Feb 8;23(1):36. open access link
(& to get clear about ExtraCorporeal Life Support, do not forget previous one… even if it was published in 2018: extensive, consistent & unambiguous nomenclature for the description of the practice of ECLS & ECMO.
Conrad S, Broman LM, Taccone FS, Lorusso R, Malfertheiner MV, Pappalardo F, Di Nardo M, Belliato M, Grazioli L, Barbaro RP, McMullan DM, Pellegrino V, Brodie D, Bembea MM, Fan E, Mendonca M, Diaz R, Bartlett RH. The Extracorporeal Life Support Organization Maastricht Treaty for Nomenclature in Extracorporeal Life Support. A Position Paper of the Extracorporeal Life Support Organization. Am J Respir Crit Care Med. 2018 Aug 15;198(4):447-451. link
And to conclude this first part of the year in review, let’s talk about the ELSO Registry: here, update and perspectives, with acknowledgement for the contribution of all centers & professionals who make up the ELSO community, for supporting this scientific initiative in the challenging ECLS field, and a thought to all the patients who were treated with ECMO support against critical illnesses and pending death.
Lorusso R, Alexander P, Rycus P, Barbaro R. The Extracorporeal Life Support Organization Registry: update and perspectives. Ann Cardiothorac Surg. 2019 Jan; 8(1): 93–98. open access link
Are you an ECMO practitioner?? Help us standardise worldwide #ECMO education! The ELSO – Extracorporeal Life Support Organization is an international non-profit consortium of health care institutions dedicated to improving extracorporeal life support through continuing education, guidelines development, research, and maintenance of a comprehensive registry of patient data. The ECMOed Taskforce is working on a collaborative approach toward standardisation of global ECMO education. Please complete this form if your centre is interested in helping with this initiative and helping outline the current state of ECMO education worldwide: follow the link to #ECMOedsurvey, just few minutes needed to fill! http://bit.ly/ELSOECMOedsurvey
Let’s introduce the faculty of ECMOed, the ECMOEducation Taskforce of the ELSO – Extracorporeal Life Support Organization, an an international consortium of Health Care Professionals dedicated to the development and delivery of high-quality education & training in the field extracorporeal support, ECLS. To start, the creators and pillars: Mark Ogino, Elso President, Bishoy Zakhary, ELSO Chair of Logistics and Education, & Rodrigo Diaz, former president of the Latin America Chapter of the Extracorporeal Life Support Organization, ELSO LATAM!
Visual abstract of the position paper to describe the state of ECMO education worldwide, noting current limitations and challenges, & to put forth an educational agenda regarding opportunities for an international collaborative approach toward standardization: a statement from the ELSO – Extracorporeal Life Support OrganizationECMOed Taskforce online first on Critical Care Medicine at http://bit.ly/ECMOedpospaper A dedicated twitter chat under the hashtag #ECMOedPP will be held in January, do not miss the opportunity to discuss the topic with the ECMOed Workgroups representatives, read the paper & stay tuned for updates!!
Zakhary B, et al. Position Paper on Global Extracorporeal Membrane Oxygenation Education and Educational Agenda for the Future: A Statement From the Extracorporeal Life Support Organization ECMOed Taskforce. Crit Care Med. 2019. http://bit.ly/ECMOedpospaper
Planning or running an ECMO course, a simulation-based course or an ECMO workshop/symposium?? The endorsement process will ensure that your event achieves an educational quality as defined by The Extracorporeal Life Support Organization! Any ELSO or non-ELSO center or scientific Society may submit application. How? in 4 easy steps, summarised in the infographic!
1. Application submission: the course or workshop/symposium director will send the initial checklist, to verify that all the preliminary criteria are met. If any hurdles is identified, recommendations will be offered to support proper adjustment before resubmitting.
2. Visit preparation: once materials are submitted and reviewed, a site survey will be scheduled. At this stage, the educational activity can be branded as ELSO-compliant.
3. Site survey: a surveyor appointed by the ECMOed Endorsement WG, not involved in the event will visit the venue while the educational activity is carried out, for a comprehensive review . At least 1 month in advance, lecture slide sets & simulation scenarios will be evaluated too. The Endorsement WG will discuss findings, to provide a final recommendation
4. Endorsement agreement: once endorsement is achieved, the ELSO Name and Logo should be used in accordance with the ‘Agreement for Use of ELSO’s Name and Materials for Training Courses’. For Comprehensive Simulation-Based ECMO Courses and ECMO courses, an ELSO standardized online pre/post-course survey and evaluation form must be administered. For workshops & symposia, an evaluation form should be administered and submitted to ELSO for review.
Train the Trainers: registrations are now open for this first-time ELSO course, run by an amazing faculty of experts from all of the five Chapters of the Extracorporeal Life Support Organization, March 17-19 2020 Vall d’Hebron Barcelona Hospital Campus: save the date!! The course will be followed by an optional one-day workshop on March 20, 2020 with simulation & boot camp.
Bishoy Zakhary – Intensivist at OHSU – Oregon Health & Science Universityin Portland OR. His primary interests are respiratory failure and the emerging role of ECMO support. He currently serves as the ELSO Chair of Logistics and Education. Twitter handle: @bishoy_zakhary Camilo Pizarro – Director of the Adult Intensive Care Unit and co-director of the adult ECMO and ventricular Assist Device Unit of the Fundación Cardiovascular de Colombia – FCV, Professor of Anesthesiology at Universidad Industrial de Santander, coordinador del Postgraduate School of Critical Care Medicine and Intensive Care of the UDES-FCV. Elizabeth Moore – Associate Director, University of Iowa Heart and Vascular Center, former ECMO Coordinator, serves as member of ELSO Education and Logistics Committee. Member of the Endorsement and of the Courses WG of ECMOed. Twitter handle: @MooreElizabethA Ibrahim Fawzy Hassan – Critical Care Director and ECMO Program Director at Hamad Medical Corporation and A/Prof of Clinical Medicine at Weill Cornell Medical College, recently has been appointed as the Chair of SWAAC ELSO. Member of the Courses WG of ECMOed. Twitter handle: @IbrahimFawzyHa1 Jan Belohlavek – Cardiologist, intensivist in Prague, Czech Republic. Assoc. Prof. of Medicine, board certified in cardiology, angiology and critical care, licenced in invasive cardiology. In charge of cardiac intensive care, ECMO team coordinator. Main clinical and research focus on refractory cardiac arrest, ECMO reperfusion, microcirculation, different ECMO settings and reperfusion. Investigator of the Prague OHCA study comparing hyperinvasive approach – ECPR to standard therapy in refractory cardiac arrest. Participates also on ECMO-CS, cardiogenic shock study evaluating the role of ECMO in severe cardiogenic shock. Chair of the Czech Association of Acute Cardiology; he is the current President of EuroELSO. Twitter handle: @jan_belohlavek Jenelle Badulak – Intensivist and emergency medicine physician, ECMO education director at the University of Washington & Harborview Medical Center, Seattle, WA. She is member of the Curriculum-Knowledge Workgroup and of the Online Education Workgroup of ECMOed. Twitter handle: @JenelleBadulak Joan Balcells – Pediatrician dedicated to pediatric critical care, with an especial interest in pediatric cardiorespiratory failure, congenital heart disease and heart or lung transplantation in children, extracorporeal life support (ECMO and ventricular assist devices. Director of the Pediatric Critical Care Department since 2011 and of the Pediatric & Neonatal ECMO Program since 2007 at Vall d’Hebron Barcelona Hospital Campus. Jordi Riera – Intensivist, Critical Care Department and ECMO team at Vall d’Hebron Barcelona Hospital Campus, his priority is to achieve excellence in three areas: patient care, research and training of residents; he is resident tutor and researcher in the area of critical respiratory patients, especially in ECMO and lung transplant. Jordi is currently member of the EuroELSO Steering Committee. Twitter handle: @jrdelbrio Leen Vercaemst – Currently working as a Nurse Specialist ECLS /Perfusionist in the University Hospital of Leuven (Belgium). Next to my clinical work as a perfusionist in a pediatric & adult cardiac surgery program, I’m involved in numerous educational projects such as coordinating the Leuven Perfusion School, leading national & international ECMO trainings as well as high fidelity simulation workshops related to ECMO/CPB. Currently member of the Board of EBCP and EuroELSO, as a liaison between the European perfusion society and EuroELSO, and member of the EuroELSO Steering Committee. Mark Ogino – Chief Partnership Officer of the Nemours Children’s Health System at the Alfred – duPont Hospital for Children in Wilmington, Delaware, and Neonatology Chief, Nemours Delaware Valley. His academic appointment of Clinical Professor of Pediatrics is with the Sydney Kimmel Medical College at Thomas Jefferson University. Dr. Ogino is the current President of ELSO and served as the Chair of Logistics and Education from 2009 to 2015. His passion is helping clinical teams learn to deliver safe and quality ECLS care at the bedside. Twitter handle: @OginoMark Mirko Belliato – Intensivist, Senior Consultant, Medical Director of the Advanced Respiratory ICU and leader of the multidisciplinary team for ECMO support at Foundation IRCCS Policlinico San Matteo, Italy. Adjunct Professor of Anesthesiology and Intensive Care at the University of Pavia, Member of the Steering Committee of EuroELSO, since 2016 he is involved in the ELSO activity as leader of the EuroELSO workgroup for “Innovation on ECMO and ECLS”, and as member of the ELSO adult ECMO and the EuroELSO workgroup for “Neuromonitoring on ECMO”. Twitter handle: @BelliatoMirko Natalia Seguel – Critical Care Nurse and simulation coordinator in Clinica las Condes, Santiago, Chile. Rodrigo Diaz – Cardiovascular Anesthesiologist, Master in Education, Master in Administration. Chief of the ECMO Unit in Clinica las Condes, Santiago, Chile. Former president of the Latin America Chapter of the Extracorporeal Life Support Organization, ELSO LATAM. Member of the Endorsement and of the Courses WG of ECMOed. Twitter handle: @EcmoDiaz Simon Sin – Specialist in Critical Care Medicine, consultant of Department of Adult Intensive Care and ECMO program leader at Queen Mary Hospital (ELSO Center of Excellence – Gold level award), Hospital Authority, HK. Accredited fellowship in Critical Care Medicine (2008), Cardiology (2012), Advance Internal Medicine (2009) (Hong Kong College of Physicians). He is Education Co-Chair/member of the Steering Committee of ELSO Asia-Pacific Chapter (APELSO). Velia Antonini – Critical Care Nurse for I° ICU/Procurement Team University Hospital of Parma, trained as ECMO specialist, Cardiovascular Perfusionist and Sonographer, is lecturer BS in Cardiocirculatory Physiopathology and Cardiovascular Perfusion at UNIMORE, Italy. Member of Online Education WG of the ECMOed and EuroELSO Steering Committee. Is ELSO Social Media Editor, & member of ASAIO Journal, ESIMC, IFAD SoMe Teams. Twitter handle: @foamecmo Wallace Ngai – Critical Care Physician, Adult Intensive Care Unit, Queen Mary Hospital in Hong Kong. His special interests are ECMO Simulation Training and Cannulation Training. He’s the Co-Chairman of the ELSO Cannulation Workshop. Twitter handle: @wallacengai
Topics: Adult learning model Designing Effective Lecture Crisis resource management Learning objectives development Simulation setups: Circuits, pumps Design, set up, and perform simulations Physiologic monitor set up and programming Monitor and ECMO circuit manipulation practice Scenario development & Debriefing techniques Competency assessment ELSO ECMOed approach Certification ELSO ECMOed approach Endorsement Process ELSO ECMOed approach Marketing and Social Media Organization, finances and balances.
The ECMO Education ECMOed Taskforce is an international consortium of health-care professionals dedicated to the development and delivery of high-quality ECMO educational activities. Primary to the mission is an international and collaborative approach to identifying and addressing ECMO educational needs. ECMOed seeks to be the guiding international and multi-professional commission within ELSO. We are committed to a collaborative approach to ECMO education with the goal of defining international standards applicable across the 5 ELSO chapters.