Introduction:

Pediatric extracorporeal membrane oxygenation (ECMO) is a high risk, low-volume technology. Infrequency of this technology and associated complications may translate to unfamiliarity of identification and management of potentially life-threatening
events. Health care providers (HCP) involved in managing ECMO must be able to promptly identify and initiate management for such
events.

Methods:

A multidisciplinary ECMO simulation program was implemented in a tertiary children’s hospital. Over 18 months, a prospective, observational study was conducted evaluating simulations involving circuit and patient emergencies, teamwork and communication behaviors and technical skills. An on-line survey was sent to participants following sessions to evaluate post-simulation confidence,
lessons learned and potential barriers to implementation of necessary skills and behaviors.

Results:

Ten simulation sessions occurred during implementation. Mean participants per session was 7 (range: 5-11). Eight PCICU
attendings, four APNs, 54 RNs (PCICU/PICU), and 55 pediatric RTs attended. Tasks with highest self-reported increase in confidence were
related to 1) diagnosis (tension pneumothorax, oxygenator failure, and ventricular tachycardia), 2) fluid administration and 3) early and
efficient mobilization for ECPR. More than 90% of participants provided a task or behavior they would implement if a specific emergency
was encountered in real-life. Real-life application did occur following simulations with participants reporting direct impact of training on
their ability to perform the skill efficiently and correctly.

Conclusions:

Implementation of ECMO multidisciplinary simulations provides structured opportunities for the team to learn and practice
ECMO skills together. Ensuring competency of healthcare professionals through implementation of such a program may improve patient
safety through enhanced team communication, knowledge, and hands-on experience.