[TJS2-4] ECMO training program in Japan
【
ライブ配信】
In Japan veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been used since 1990s to resuscitate reversible cardiovascular failure. Because of the rapid implementation of VA-ECMO without dedicated training program, novices must learn only through the real patient. This lack of training might lead to malpractices. In contrast veno-venous ECMO (VV-ECMO) as the rescue therapy for severe acute respiratory distress syndrome (ARDS) is a relatively new strategy in Japan, therefore Japanese practitioners have not been used to VV-ECMO management. Because of the unsatisfied outcome of severe ARDS patients due to 2009 H1N1 Influenza in Japan compared to other advanced ECMO centers in the world, Japanese experts recognized that developing VV-ECMO training program should be urgent. Thus the need for ECMO training program had motivated some experts.As to VV-ECMO, the core members of Japanese Society of Respiratory Care Medicine have developed ECMO simulation seminar in 2013. This one-and-a-half-day course includes the didactic lectures, skill stations and scenario training. The application should be done as a 3-person multidisciplinary team including a physician, a nurse and a perfusionist. From July 2013 to August 2018, 12 courses were held. In the last 10 courses there were 261 attendees of 120 physicians, 68 nurses and 73 perfusionists. The lectures consist of several themes of ECMO basics. Skill stations include preparing/changing the circuit, deairation, priming/changing the membrane and trouble shooting in device failure or power loss. Scenario training includes the cases requiring specific trouble shooting such as air in the circuit, pump failure and transition to VA-ECMO.As to VA-ECMO, we developed the original half-day seminar including cannulation hands-on training with the original vascular model in 2013. In 2016 the seminar was changed into a one-day program including both cannulation training and team scenario simulation. The application should be done as a 5 to 7-person multidisciplinary team. During May 2016 to October 2018, 33 courses were held, and total 342 attendees of 162 physicians, 103 nurses and 77 perfusionists joined.Hands-on training is helpful to master the skills related to ECMO management. Moreover team scenario training is crucial to integrate their knowledge and skills and make decision to initiate and manage ECMO as a team.