ECMO Service Implementation
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Essentials to start an ECMO Service in any Center, how to think and how to plan. by exploring the market, along with some analysis, figures and data. Planning is the key to success with any project
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ECMO Service Implementation
- 1. ECMO/ECLS Service Implementation page 1 By: Eng. Mohamed Ibrahim Medical Elements Co Getinge – Maquet Cardiopulmonary Cardiopulmonary &Cardiac Surgery Area Manager Author: Mohamed Ibrahim
- 2. • Extracorporeal membrane oxygenation (ECMO) is the application of a modified cardiopulmonary bypass for cardiac or respiratory failure not responding to conventional measures or treatments. • The term extracorporeal membrane oxygenation (ECMO) has generally been replaced by ECLS – extracorporeal life support, reflecting an expanded role beyond oxygenation . What’s ECMO/ECLS ! Author: Eng. Mohamed Ibrahim
- 4. Page 4 Whyto ECMO!!01 Author: Eng. Mohamed Ibrahim
- 5. ECMOis used in life-threatening situations. It can be used tosupport patients whoexperience heart orlung failureafter cardiac surgery oras abridgefor patients awaiting a lung transplant orheart assist device. These common indication forAdults forECMO arebut not limited to: Expanding service for a growing need. Why ECMO Service !! Clinical indications for institution of ECMO support VA-ECMO** VV-ECMO** Weaning from cardiopulmonary bypass after cardiac surgery Any potentially reversible acute respiratory failure Bridge to cardiac transplantation ARDS. Associated with pneumonia (viral or bacterial) Acute myocarditis Failed lung transplant graft Intractable arrhythmia Trauma (pulmonary contusion) Post-cardiac arrest (as part of Advance Life Support) Pulmonary embolism (if acceptable cardiac function) Local anaesthetic toxicity Pulmonary hypertension (after pulmonary endarterectomy) **VA, Venoarterial; VV, Venovenous. Author: Eng. Mohamed Ibrahim
- 6. Acute Respiratory Distress Syndrome (ARDS) Hyaline Membrane Disease (HMD) Meconium Aspiration Syndrome (MAS)) Persistent Pulmonary Hypertension (PPHN) Congenital Diaphragmatic Hernia (CDH) Sepsis Congenital heart eCPR Air Leak Syndrome Pertussis Hypothermia PediatricECMO WhyECMOService!! Author: Eng. Mohamed Ibrahim
- 8. Detailed Pediatric & Neonate Survival Rate
- 9. WherecanIinitiateECMO ED Operating rooms (cardiac and non- cardiac) Catheterization labs Obstetric labor and delivery suites Intensive care units (medical, cardiac, surgical, neuro, etc.)
- 12. ECMOMarketTrends ECMO Service increasing at CAGR by 22% worldwide. And more than 30% in Saudi Arabia 60 300 280 450 800 20 50 60 100 100 80 350 340 550 900 0 100 200 300 400 500 600 700 800 900 1000 J/14 J/15 J/16 J/17 J/18 VV & VA in Saudi VV ECMO VA ECMO Total
- 13. DistributionOfECMOMachinesacrosstheKingdom Eastern Provience 17% Riyadh & Central Provience 37% Western Provience 46%
- 14. Author: Mohamed Ibrahim Page 14 BuildingECMO Service03
- 15. Administration Ancillary Services Any other stakeholders Clinicians The clinicians and administrators first determine the need and support for an ECMO program. This multidisciplinary group then operationalizes the care team that needs to be assembled and trained. The team includes clinical, administrative, ancillary, and other stakeholders, which are required to care for the patient and support the infrastructure, while moving the program to implementation. ImplementationProcess
- 16. ICU/ Respiratory Emergency Department Cardiac Surgery / Vascular Surgery Cardiology Palliative Care Author: Mohamed Ibrahim Page 16 ClinicalTeamMembers
- 17. Administrators from the executive team should be engaged early to help support the creation of structures to accelerate implementation, project management, and assurance of adequate capital and personnel resources for a sustainable program. Financial models, must be considered—and given the amount of resources required to establish and maintain an ECMO program, it is wise to have someone to monitor the financial implications. AdministrativeStakeholders Executives Business Development Sales & Marketing Insurance Project Management Finance Supply chain Contracting
- 21. Author: Mohamed Ibrahim Page 21 SupplyChain Contracting Hardware Consumables ECMOcart supplies Forecasting
- 22. ECMO Program Director ICU Consultant Critical care Transportation CS Purfusionist ICU Nursing Cardiologist/ Vascular surgeon Coordinator
- 23. Patient Demographics Type of support Expected Outcomes Duration of support PatientSelectionCriteria Author: Mohamed Ibrahim Page 23
- 25. Author: Mohamed Ibrahim Page 25 TimeLine 05
- 26. ECMOService Proposed Timelineforsoft Launch 2019 October Step 1 Stakeholders Meeting Review, Submit, initiate 2019 October Step 2 Signing contract with Vendor Creating teams and committee Identifying Indications to be accepted 2019 November Step 3 Weekly meeting for the committee to finalize Protocol, check list 2019 December Step 4 Starting condensed trainings, Troubleshooting Receiving Equipment's 2020 January Step 5 Soft Launch of the service Author: Mohamed Ibrahim 026
- 29. CARDIOHELP System is the world’s smallest portable heart-lung support system. It is ideal for use in: Intensive care units cardiac catheter laboratory operating room trauma room AREASOFAPPLICATIONWITH CARDIOHELP
- 30. Transportation CARDIOHELP Device weighs in at approx. 11 kg and can easily be carried by one person and is sufficiently compact to be used during transport. The system is used in emergencies to restore stabilize the patient’s cardiopulmonary functions. It may have to be used during cardiopulmonary resuscitation caused by, amongst others: Anaphylactic shock Intoxication Hypothermia AREASOFAPPLICATIONWITH CARDIOHELP
- 31. Getinge is a leading global provider of innovative solutions for operating rooms, intensive-care units, hospital wards, sterilization departments and for life science companies and institutions. Based on our first-hand experience and close partnerships, we are improving the every-day life for people, today and tomorrow. www.getinge.com 0542885507 Mibrahim@medicalelementsco.com Area Manager Eng.: Mohamed Ibrahim Getinge – Medical Elements Confidentiality Notice: This document is confidential and contains proprietary information and intellectual property of Mohamed Ibrahim. Neither this document nor any of the information contained herein may be reproduced or disclosed under any circumstances without the express written permission of Mohamed Ibrahim. Please be aware that disclosure, copying, distribution or use of this document and the information contained therein is strictly prohibited.