Efficacy of a Single Day Extracorporeal Membrane Oxygenation Training Course for Critical Care Air Transport Team Eligible Personnel
ABSTRACT Background Extracorporeal membrane oxygenation (ECMO) is an advanced medical technology that is used to treat respiratory and heart failure. The U.S. military has used ECMO in the care of combat casualties during Operation Enduring Freedom and Operation Iraqi Freedom as well as in the treat...
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| Veröffentlicht in: | Military medicine 2024-08, Vol.189 (9-10), p.e2211-e2219 |
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| creator | Paredes, R Madelaine Inman, Brannon Davis, William T Castaneda, Maria Mireles, Allyson A Baldwin, Darren S Rodriguez, Dylan C Medellin, Kimberly L Ng, Patrick C Maddry, Joseph K |
| description | ABSTRACT
Background
Extracorporeal membrane oxygenation (ECMO) is an advanced medical technology that is used to treat respiratory and heart failure. The U.S. military has used ECMO in the care of combat casualties during Operation Enduring Freedom and Operation Iraqi Freedom as well as in the treatment of patients during the recent Coronavirus Disease 2019 pandemic. However, few Military Health System personnel have training and experience in the use of ECMO therapy. To address this dearth of expertise, we developed and evaluated an accelerated ECMO course for military medical personnel.
Objectives
To compare the efficacy of an accelerated ECMO course for Military Health System critical care teams.
Methods
Seventeen teams, each consisting of a physician and nurse, underwent a 5-h accelerated ECMO course. Similar to our previous live-tissue ECMO training program (phases I and II), each team watched prerecorded ECMO training lectures. Subjects then practiced priming the ECMO circuit, cannulating ECMO, initiating ECMO, and correcting common complications on an ECMO simulation model. An added component to this phase III project included transportation and telemedicine consultation availability. Training success was evaluated via knowledge and confidence assessments, and observation of each team attempting to initiate ECMO on a Yorkshire swine patient model, transport the patient model, and troubleshoot complications with the support of telemedicine consultation when desired.
Results
Seventeen teams successfully completed the course. All seventeen teams (100%) successfully placed the swine on veno-arterial ECMO. Of those, 15 teams successfully transitioned to veno-arterial-venous ECMO. The knowledge assessments of physicians and nurses increased by 12.2% from pretest (mean of 62.1%, SD 10.4%) to posttest (mean of 74.4%, SD 8.2%), P |
| doi_str_mv | 10.1093/milmed/usae138 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3049716412</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/milmed/usae138</oup_id><sourcerecordid>3049716412</sourcerecordid><originalsourceid>FETCH-LOGICAL-c242t-4118d65fb099f1c230176166a78a9928c20949d0adc8bba83ac2f8b907760cb73</originalsourceid><addsrcrecordid>eNqFkU1rGzEQhkVpady01x6LoJf2sMlotdbHMWzcNpCQQF3obZmVJaOgXbnSLsT3_vDK2Ln0ktPA8MwzM7yEfGRwwUDzy8GHwW4u54yWcfWKLJjmUAnGf78mC4BaVA3I5Rl5l_MjAGu0Ym_JGVdCSdHIBfm7cs4bNHsaHUX604_bYOk17unqaUpoYtrFZDHQOzv0CUdL75_2Wzvi5ONI1wn9WEZoG-eULXUx0Tb5qRgDbTFZeuXTgRpz0Ux0bXGgq-C3vi9bHmzKcRxteE_eOAzZfjjVc_Lr22rd_qhu77_ftFe3lambeqoaxtRGLF0PWjtmag5MCiYESoVa18rUoBu9AdwY1feoOJraqV6DlAJML_k5-XL07lL8M9s8dYPPxoZQ_opz7jg0WjLRsLqgn_9DH8uLY7mu4ww4LIVWB-HFkTIp5pys63bJD5j2HYPukE93zKc75VMGPp20c3_oP-PPgRTg6xGI8-4l2T9XeJyO</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3103056987</pqid></control><display><type>article</type><title>Efficacy of a Single Day Extracorporeal Membrane Oxygenation Training Course for Critical Care Air Transport Team Eligible Personnel</title><source>MEDLINE</source><source>Oxford Journals</source><creator>Paredes, R Madelaine ; Inman, Brannon ; Davis, William T ; Castaneda, Maria ; Mireles, Allyson A ; Baldwin, Darren S ; Rodriguez, Dylan C ; Medellin, Kimberly L ; Ng, Patrick C ; Maddry, Joseph K</creator><creatorcontrib>Paredes, R Madelaine ; Inman, Brannon ; Davis, William T ; Castaneda, Maria ; Mireles, Allyson A ; Baldwin, Darren S ; Rodriguez, Dylan C ; Medellin, Kimberly L ; Ng, Patrick C ; Maddry, Joseph K</creatorcontrib><description>ABSTRACT
Background
Extracorporeal membrane oxygenation (ECMO) is an advanced medical technology that is used to treat respiratory and heart failure. The U.S. military has used ECMO in the care of combat casualties during Operation Enduring Freedom and Operation Iraqi Freedom as well as in the treatment of patients during the recent Coronavirus Disease 2019 pandemic. However, few Military Health System personnel have training and experience in the use of ECMO therapy. To address this dearth of expertise, we developed and evaluated an accelerated ECMO course for military medical personnel.
Objectives
To compare the efficacy of an accelerated ECMO course for Military Health System critical care teams.
Methods
Seventeen teams, each consisting of a physician and nurse, underwent a 5-h accelerated ECMO course. Similar to our previous live-tissue ECMO training program (phases I and II), each team watched prerecorded ECMO training lectures. Subjects then practiced priming the ECMO circuit, cannulating ECMO, initiating ECMO, and correcting common complications on an ECMO simulation model. An added component to this phase III project included transportation and telemedicine consultation availability. Training success was evaluated via knowledge and confidence assessments, and observation of each team attempting to initiate ECMO on a Yorkshire swine patient model, transport the patient model, and troubleshoot complications with the support of telemedicine consultation when desired.
Results
Seventeen teams successfully completed the course. All seventeen teams (100%) successfully placed the swine on veno-arterial ECMO. Of those, 15 teams successfully transitioned to veno-arterial-venous ECMO. The knowledge assessments of physicians and nurses increased by 12.2% from pretest (mean of 62.1%, SD 10.4%) to posttest (mean of 74.4%, SD 8.2%), P < .0001; their confidence assessments increased by 41.1% from pretest (mean of 20.1%, SD 11.8%) to posttest (mean of 61.2%, SD 18.6%).
Conclusions
An abbreviated 1-day lecture and hands-on task-trainer-based ECMO course resulted in a high rate of successful skill demonstration and improvement of physicians’ and nurses’ knowledge assessments and confidence levels, similar to our previous live-tissue training program. When compared to our previous studies, the addition of telemedicine and patient transportation to this study did not affect the duration or performance of procedures.</description><identifier>ISSN: 0026-4075</identifier><identifier>ISSN: 1930-613X</identifier><identifier>EISSN: 1930-613X</identifier><identifier>DOI: 10.1093/milmed/usae138</identifier><identifier>PMID: 38687647</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Air Ambulances ; Armed forces ; COVID-19 - epidemiology ; COVID-19 - therapy ; Critical care ; Critical Care - methods ; Extracorporeal membrane oxygenation ; Extracorporeal Membrane Oxygenation - education ; Extracorporeal Membrane Oxygenation - methods ; Humans ; Military health care ; Military Personnel - statistics & numerical data ; Pandemics ; SARS-CoV-2 ; Teams ; Telemedicine ; Training ; United States</subject><ispartof>Military medicine, 2024-08, Vol.189 (9-10), p.e2211-e2219</ispartof><rights>Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US. 2024</rights><rights>Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c242t-4118d65fb099f1c230176166a78a9928c20949d0adc8bba83ac2f8b907760cb73</cites><orcidid>0000-0002-1017-5619 ; 0000-0003-1236-4322</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38687647$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paredes, R Madelaine</creatorcontrib><creatorcontrib>Inman, Brannon</creatorcontrib><creatorcontrib>Davis, William T</creatorcontrib><creatorcontrib>Castaneda, Maria</creatorcontrib><creatorcontrib>Mireles, Allyson A</creatorcontrib><creatorcontrib>Baldwin, Darren S</creatorcontrib><creatorcontrib>Rodriguez, Dylan C</creatorcontrib><creatorcontrib>Medellin, Kimberly L</creatorcontrib><creatorcontrib>Ng, Patrick C</creatorcontrib><creatorcontrib>Maddry, Joseph K</creatorcontrib><title>Efficacy of a Single Day Extracorporeal Membrane Oxygenation Training Course for Critical Care Air Transport Team Eligible Personnel</title><title>Military medicine</title><addtitle>Mil Med</addtitle><description>ABSTRACT
Background
Extracorporeal membrane oxygenation (ECMO) is an advanced medical technology that is used to treat respiratory and heart failure. The U.S. military has used ECMO in the care of combat casualties during Operation Enduring Freedom and Operation Iraqi Freedom as well as in the treatment of patients during the recent Coronavirus Disease 2019 pandemic. However, few Military Health System personnel have training and experience in the use of ECMO therapy. To address this dearth of expertise, we developed and evaluated an accelerated ECMO course for military medical personnel.
Objectives
To compare the efficacy of an accelerated ECMO course for Military Health System critical care teams.
Methods
Seventeen teams, each consisting of a physician and nurse, underwent a 5-h accelerated ECMO course. Similar to our previous live-tissue ECMO training program (phases I and II), each team watched prerecorded ECMO training lectures. Subjects then practiced priming the ECMO circuit, cannulating ECMO, initiating ECMO, and correcting common complications on an ECMO simulation model. An added component to this phase III project included transportation and telemedicine consultation availability. Training success was evaluated via knowledge and confidence assessments, and observation of each team attempting to initiate ECMO on a Yorkshire swine patient model, transport the patient model, and troubleshoot complications with the support of telemedicine consultation when desired.
Results
Seventeen teams successfully completed the course. All seventeen teams (100%) successfully placed the swine on veno-arterial ECMO. Of those, 15 teams successfully transitioned to veno-arterial-venous ECMO. The knowledge assessments of physicians and nurses increased by 12.2% from pretest (mean of 62.1%, SD 10.4%) to posttest (mean of 74.4%, SD 8.2%), P < .0001; their confidence assessments increased by 41.1% from pretest (mean of 20.1%, SD 11.8%) to posttest (mean of 61.2%, SD 18.6%).
Conclusions
An abbreviated 1-day lecture and hands-on task-trainer-based ECMO course resulted in a high rate of successful skill demonstration and improvement of physicians’ and nurses’ knowledge assessments and confidence levels, similar to our previous live-tissue training program. When compared to our previous studies, the addition of telemedicine and patient transportation to this study did not affect the duration or performance of procedures.</description><subject>Air Ambulances</subject><subject>Armed forces</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - therapy</subject><subject>Critical care</subject><subject>Critical Care - methods</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Extracorporeal Membrane Oxygenation - education</subject><subject>Extracorporeal Membrane Oxygenation - methods</subject><subject>Humans</subject><subject>Military health care</subject><subject>Military Personnel - statistics & numerical data</subject><subject>Pandemics</subject><subject>SARS-CoV-2</subject><subject>Teams</subject><subject>Telemedicine</subject><subject>Training</subject><subject>United States</subject><issn>0026-4075</issn><issn>1930-613X</issn><issn>1930-613X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1rGzEQhkVpady01x6LoJf2sMlotdbHMWzcNpCQQF3obZmVJaOgXbnSLsT3_vDK2Ln0ktPA8MwzM7yEfGRwwUDzy8GHwW4u54yWcfWKLJjmUAnGf78mC4BaVA3I5Rl5l_MjAGu0Ym_JGVdCSdHIBfm7cs4bNHsaHUX604_bYOk17unqaUpoYtrFZDHQOzv0CUdL75_2Wzvi5ONI1wn9WEZoG-eULXUx0Tb5qRgDbTFZeuXTgRpz0Ux0bXGgq-C3vi9bHmzKcRxteE_eOAzZfjjVc_Lr22rd_qhu77_ftFe3lambeqoaxtRGLF0PWjtmag5MCiYESoVa18rUoBu9AdwY1feoOJraqV6DlAJML_k5-XL07lL8M9s8dYPPxoZQ_opz7jg0WjLRsLqgn_9DH8uLY7mu4ww4LIVWB-HFkTIp5pys63bJD5j2HYPukE93zKc75VMGPp20c3_oP-PPgRTg6xGI8-4l2T9XeJyO</recordid><startdate>20240830</startdate><enddate>20240830</enddate><creator>Paredes, R Madelaine</creator><creator>Inman, Brannon</creator><creator>Davis, William T</creator><creator>Castaneda, Maria</creator><creator>Mireles, Allyson A</creator><creator>Baldwin, Darren S</creator><creator>Rodriguez, Dylan C</creator><creator>Medellin, Kimberly L</creator><creator>Ng, Patrick C</creator><creator>Maddry, Joseph K</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1017-5619</orcidid><orcidid>https://orcid.org/0000-0003-1236-4322</orcidid></search><sort><creationdate>20240830</creationdate><title>Efficacy of a Single Day Extracorporeal Membrane Oxygenation Training Course for Critical Care Air Transport Team Eligible Personnel</title><author>Paredes, R Madelaine ; Inman, Brannon ; Davis, William T ; Castaneda, Maria ; Mireles, Allyson A ; Baldwin, Darren S ; Rodriguez, Dylan C ; Medellin, Kimberly L ; Ng, Patrick C ; Maddry, Joseph K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c242t-4118d65fb099f1c230176166a78a9928c20949d0adc8bba83ac2f8b907760cb73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Air Ambulances</topic><topic>Armed forces</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - therapy</topic><topic>Critical care</topic><topic>Critical Care - methods</topic><topic>Extracorporeal membrane oxygenation</topic><topic>Extracorporeal Membrane Oxygenation - education</topic><topic>Extracorporeal Membrane Oxygenation - methods</topic><topic>Humans</topic><topic>Military health care</topic><topic>Military Personnel - statistics & numerical data</topic><topic>Pandemics</topic><topic>SARS-CoV-2</topic><topic>Teams</topic><topic>Telemedicine</topic><topic>Training</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paredes, R Madelaine</creatorcontrib><creatorcontrib>Inman, Brannon</creatorcontrib><creatorcontrib>Davis, William T</creatorcontrib><creatorcontrib>Castaneda, Maria</creatorcontrib><creatorcontrib>Mireles, Allyson A</creatorcontrib><creatorcontrib>Baldwin, Darren S</creatorcontrib><creatorcontrib>Rodriguez, Dylan C</creatorcontrib><creatorcontrib>Medellin, Kimberly L</creatorcontrib><creatorcontrib>Ng, Patrick C</creatorcontrib><creatorcontrib>Maddry, Joseph K</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Docstoc</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Military medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paredes, R Madelaine</au><au>Inman, Brannon</au><au>Davis, William T</au><au>Castaneda, Maria</au><au>Mireles, Allyson A</au><au>Baldwin, Darren S</au><au>Rodriguez, Dylan C</au><au>Medellin, Kimberly L</au><au>Ng, Patrick C</au><au>Maddry, Joseph K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of a Single Day Extracorporeal Membrane Oxygenation Training Course for Critical Care Air Transport Team Eligible Personnel</atitle><jtitle>Military medicine</jtitle><addtitle>Mil Med</addtitle><date>2024-08-30</date><risdate>2024</risdate><volume>189</volume><issue>9-10</issue><spage>e2211</spage><epage>e2219</epage><pages>e2211-e2219</pages><issn>0026-4075</issn><issn>1930-613X</issn><eissn>1930-613X</eissn><abstract>ABSTRACT
Background
Extracorporeal membrane oxygenation (ECMO) is an advanced medical technology that is used to treat respiratory and heart failure. The U.S. military has used ECMO in the care of combat casualties during Operation Enduring Freedom and Operation Iraqi Freedom as well as in the treatment of patients during the recent Coronavirus Disease 2019 pandemic. However, few Military Health System personnel have training and experience in the use of ECMO therapy. To address this dearth of expertise, we developed and evaluated an accelerated ECMO course for military medical personnel.
Objectives
To compare the efficacy of an accelerated ECMO course for Military Health System critical care teams.
Methods
Seventeen teams, each consisting of a physician and nurse, underwent a 5-h accelerated ECMO course. Similar to our previous live-tissue ECMO training program (phases I and II), each team watched prerecorded ECMO training lectures. Subjects then practiced priming the ECMO circuit, cannulating ECMO, initiating ECMO, and correcting common complications on an ECMO simulation model. An added component to this phase III project included transportation and telemedicine consultation availability. Training success was evaluated via knowledge and confidence assessments, and observation of each team attempting to initiate ECMO on a Yorkshire swine patient model, transport the patient model, and troubleshoot complications with the support of telemedicine consultation when desired.
Results
Seventeen teams successfully completed the course. All seventeen teams (100%) successfully placed the swine on veno-arterial ECMO. Of those, 15 teams successfully transitioned to veno-arterial-venous ECMO. The knowledge assessments of physicians and nurses increased by 12.2% from pretest (mean of 62.1%, SD 10.4%) to posttest (mean of 74.4%, SD 8.2%), P < .0001; their confidence assessments increased by 41.1% from pretest (mean of 20.1%, SD 11.8%) to posttest (mean of 61.2%, SD 18.6%).
Conclusions
An abbreviated 1-day lecture and hands-on task-trainer-based ECMO course resulted in a high rate of successful skill demonstration and improvement of physicians’ and nurses’ knowledge assessments and confidence levels, similar to our previous live-tissue training program. When compared to our previous studies, the addition of telemedicine and patient transportation to this study did not affect the duration or performance of procedures.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>38687647</pmid><doi>10.1093/milmed/usae138</doi><orcidid>https://orcid.org/0000-0002-1017-5619</orcidid><orcidid>https://orcid.org/0000-0003-1236-4322</orcidid></addata></record> |
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| source | MEDLINE; Oxford Journals |
| subjects | Air Ambulances Armed forces COVID-19 - epidemiology COVID-19 - therapy Critical care Critical Care - methods Extracorporeal membrane oxygenation Extracorporeal Membrane Oxygenation - education Extracorporeal Membrane Oxygenation - methods Humans Military health care Military Personnel - statistics & numerical data Pandemics SARS-CoV-2 Teams Telemedicine Training United States |
| title | Efficacy of a Single Day Extracorporeal Membrane Oxygenation Training Course for Critical Care Air Transport Team Eligible Personnel |
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