Rush Blogging: Extra ECMO

Of the past seven days, I've worked six days. One totally extra day. One 16 hour shift. And four regular 12 hour shifts. I'm exhausted. When T called me while I was in Raleigh to see if I wanted to pick up a shif last week for ECMO, I thought she was joking. I'dd come to expect that we would never again do ECMO on the PICU again. But, the call came from anotehr PICU, was referred to us by a prior fellow, and the attending on-duty was ECMO-friendly. So it was that we took the first ECMO patient on the unit (there have been others in the NICU and CTICU) in 18 months.

There were several saving graces.

First, it was Dr. Metro and Tan Shaggy on. They are my favorite attending-fellow team to work with. They are smart, good communicators, skilled, and fun to be with. The nurses don't ahve to worry about questioning the fellow's judgement, or worrying that the attending's disposition is going to be off-kilter.

Second, the mother was studying to be a nurse. She was very interested in everything we did, but not in an instrusive way. When I started talking to her, we got along very well, she asked intelligent questions, understood much of what was said, and was always grateful for however we could include her in her chid's care. She was also very realistic about the potential outcomes for her child. It seemed as if the rest of the family was in denial about how sick the patient was, despite all the many high level interventions.

Third, the whole EMCO team rallied. The ECMO coordinator was able to pitch in a lot to help us run the circuit, and relieve us for breaks. Many of the PICU ECMO team members who had quit the team got recerted quickly and came back to work either with the patient or the pump. And there was a lot of support from the other ICU's in providing the second nurse needed to take care of the patient and pump.

We'll have to see what happens next with the PICU ECMO team.