ECMO Simulation is an emerging speciality educational and training opportunity that is rapidly expanding within the field of healthcare. Simulated trainers for Extracorporeal Membrane Oxygenation (ECMO) allows healthcare professionals the opportunity to practice the skills of initiating and life-saving techniques. ECMO is a form of life support for people with life-threatening illness or injury that affects the function of their heart or lungs. ECMO keeps blood moving through the body and keeps oxygen and carbon dioxide in balance. This form of life support is used to provide prolonged cardiac and respiratory assistance for patients who have heart and lung conditions that are unable to maintain an adequate amount of perfusion. ECMO may be an option when other life support measures have not worked.
Proper training across medical education helps to prevent medical errors and ensure that learners are prepared to perform life-saving measures, such as ECMO. The skill of ECMO has been difficult to practice in the past due to limited simulation platforms to help train physicians, perfusionists, and other healthcare providers on the fundamental steps of access, cannulation, and connection to ECMO.
Previously, an ECMO educator was present in the sim environment, manually manipulating the circuit in the presence of the trainee. As institutions began to develop their own ECMO simulations many realized that higher-fidelity simulation would not be possible without the development of a remote controlled simulator connected to the ECMO circuit to increase scenario fidelity (or realism). Several companies have created ECMO simulators and educational programs incorporating simulation to help healthcare providers perfect this difficult skill without practicing on real patients. Honing ECMO skills will lead to better patient outcomes.
Efficacy of ECMO Simulation
Research such as Long-term efficacy of an extracorporeal membrane oxygenation simulation with a novel, low-cost vascular model “Endo-Circuit” (Endo et al., 2017) has demonstrated that long-term efficacy of ECMO knowledge, skills, and attitudes of healthcare practitioners has been obtained with ECMO simulation. Another study A skills acquisition study on ECMOjo: a screen-based simulator for extracorporeal membrane oxygenation (Alsalemi et al., 2020) demonstrated the use of a screen based ECMO simulation is comparable to didactic and manikin simulation on learners’ reported self-efficacy and complementary to manikin-based simulation scenarios in a cost-effective manner.
ECMO Simulator Product Examples
Healthcare Simulation vendors provide the latest medical simulation technologies to improve education, training, and patient safety outcomes in clinical institutions around the world. Composed of manufacturers, service providers, and distributors, the clinical simulation corporations and organizations below can provide simulation centers with the latest ECMO Simulators, software, and support to ensure performance improvement outcomes and meaningful ROI.
Clinical simulation educators and simulation operations specialists should understand that some ECMO Simulator products require additional equipment and support resources. One must take this into consideration when budgeting and purchasing products. Some ECMO simulators or simulation software require additional full body manikins, laptops or personal electronic devices, and/or ECMO circuits to function properly. Clinical simulationists should always carefully review the manufacturer details to best meet their simulation program’s needs.
EigenFlow and EigenFlow 2 Advanced from Curtis Life Research (CLR)
Curtis Life Research’s EigenFlow and EigenFlow 2 Advanced are multifunctional intuitive iOS interfaces for wireless ECMO simulators ideal for in situ training of perfusionists and ECMO specialists. Simply interpose the EigenFlow into your existing adult or pediatric ECMO circuit and remotely simulate thrombi, line obstruction, air emboli, and changes in pulmonary and cardiac function. With one hand, controlling the CLR EigenFlow allows control of manikin vitals with the other. EigenFlow connects wirelessly through Bluetooth, so you can control simulations from up to 100 feet. Simply interpose the EigenFlow into your existing adult or pediatric ECMO circuit and remotely simulate thrombi, line obstruction, air emboli, hypovolemia, and changes in pulmonary and cardiac function. With the newly featured Advanced model CLR EigenFlow now features 12 built in scenarios and a variety of new blood parameters.
Heartbeat Perfusion Solutions
Heartbeat Perfusion Solutions offers a full range of qualified professionals to meet a facility’s unique perfusion staffing challenges. The company’s mission is to deliver high-quality comprehensive perfusion services with excellence, compassion, and competence. Heartbeat Perfusion Solutions offers a wide range of highly-experienced professionals ready to fulfill all ECMO clinician’s staffing needs. The company’s consulting services have been designed to assist with new program development and/or review of existing ECMO programs. This includes medical training simulations for healthcare professionals looking to extend their knowledge and practice on ECMO procedures. Heartbeat Perfusion Solutions’ Comprehensive ECMO course uses a combination of didactic, practical, and immersive simulated scenarios with variable Mankins and circuit physiology models.
Additionally, the ECMO Simulation Center utilizes a novel approach to hands-on education where not only medical care is taught but where interpersonal, teamwork, and patient-safety skills can be demonstrated and tested. The comprehensive ECMO training program has been designed and structured in accordance with the accreditation requirements of the Accreditation Council for Continuing Medical Education (ACCME) and the guidelines of the Extracorporeal Life Support Organization (ELSO).
Modular Simulation Environment (MSE) ECMO
The Modular Simulation Environment ECMOsimulator is a screen-based implementation of a high-fidelity, medical simulation system. The MSE is intended for teaching the principles of VV and VA ECMO to those working in the fields of anesthesia, intensive care, or perfusion. MSE ECMO can be used to simulate both veno-venous (VV) and veno-arterial (VA) ECMO in adults.
The simulator can be installed on computers and designed for use by single users or small groups. The ECMO simulator incorporates various MSE components which include a:
virtual patient. The patient consists of about 20 real-time models, which can be adjusted by a supervisor to reproduce a wide variety of clinical states. The trainee can then treat the patient using any of the available devices or drugs.
Simul8 ECMO Cannulation & Flow Simulator
The Simul8 ECMO Cannulation & Flow Simulator is a Hybrid ECMO simulator that can be used as a tabletop task trainer for rapid-cycle-deliberate-practice and skill acquisition, or in concert with a high-technology manikin for a truly immersive simulation experience. This product comes with two skin pads, one cannulation pad, and one sub-xiphoid pad for wire/cannula placement confirmation. For more from Simul8, watch the LEARN Platform webinar “How to Design a Healthcare Simulator: From Ideation to Market Commercialization.” This webinar will demonstrate the necessary steps to developing a new medical simulator, including company formation, patent application, legal consultation, product design, prototyping, evaluation, revisioning, manufacturing, and sales. Simulat8 is designed to be intuitive, fast, and effective to allow users to collaborate to build, run, and share simulations from a browser anywhere. Simul8 is a game-changing software product.
BioMed Simulation’s Califia
BioMed Simulation’s (BMS) mission is to improve clinician performance through patient-free clinical simulation. The company’s initial products include healthcare simulation modules for the operation of the Heart Lung Machine – Cardiopulmonary Bypass (CPB) and the ECMO machine used in long-term cardiopulmonary support. BMS’ platform roadmap includes other simulators, data analytics interfaces, and guideline-based test patient scenarios to continually improve clinician performance and address Healthcare providers concerns.
BioMed Simulation’s Califia is the de-facto standard for simulating extracorporeal circulation. Califia’s physiologic response system is agnostic to all Extracorporeal Circulation Life Support (ECLS) and Heart-Lung Machines (HLM), so there are never compatibility concerns. Optionally, in standalone mode, Califia can represent many clinical situations without the need for additional devices featuring realistic hemodynamic and respiratory changes. Califia can be used in an in-situ clinical environment, simulation center, or in a virtual environment with or without an organization’s equipment on infant, pediatric, and adult patient scenarios. Califia also incorporates a highly-durable, low-maintenance, and portable design.
The Chamberlain Group has a new patient manikin for emergent CardioPulmonary Bypass (CPB) with V-V ECMO. The healthcare simulation scenario engages surgeons, residents, and the entire clinical team in immersive ECMO/CPB simulation training. The Enhanced ECMO/Perfusion Team Trainer is the cardiac surgical mannequin for perfusion/CPB simulations have been missing—interfacing with your Califia or Orpheus simulator system and ECMO or Heart/Lung Machine (not included) to bring the virtual patient off the screen and onto the operating table.
The Chamberlain Group patented technology, accurate anatomy, and mimetic tissue make this the most realistic beating heart simulator on the market—permitting you to perform all surgical aspects of the procedure with convincing realism. The Trainer supports intubation, pressurized fluid flow, cannula placement, and coronary artery bypass grafting. Heart rate may be controlled remotely or synchronized with the signal from a patient monitor or simulator system. All soft tissue elements are easily replaced for deliberate practice in multiple training sessions. Interchangeable anatomies allow you to choose from high-fidelity or cost conscious options.
ECMOjois a simulator and trainer for ECMO ECMOjo from Perfusion.com is a computer application implemented in Java. ECMOjo is available for all major operating systems. The application consists of a graphical user interface to teach physicians, nurses and students the basics of extracorporeal membrane oxygenation.” ECMOjo has been developed by the Telehealth Research Institute (TRI), John A. Burns School of Medicine (JABSOM) of the University of Hawaii.
Innovative ECMO Concepts
Innovative ECMO Concepts was the first in the industry to offer on-demand, online ECLS training and education. Thousands of specialists in every discipline – from MDs and RNs to RRTs and perfusionists in neonatal, pediatric and adult fields have been trained. In an effort to provide training and education that fits your team’s needs, we have created three training options: blended learning, hands on training, and on-site training.
The Simulator Company E-SIM – Cannulation & Perfusion Simulator
E-SIM is for the users who want to dive into the world of Extracorporeal Circulation Life Support (ECLS) simulation and want a simple but effective simulator for practicing ECLS cannulation, connection to ECLS systems and IABP systems. E-SIm ECLS system is an excellent tool for someone beginning with ECC simulation. The cannulation and perfusion simulator allows the participant to perform all types of cannulation and connect with the ECLS System. Difficult cannulations can be created with ease using realistic scenarios. This simulator allows for a quick one person setup under five minutes to prime and initiate the simulation.
The Grainger College of Engineering University of Illinois – Ubana-Champaign
Funded by Jump ARCHES, the Grainger College of Engineering University of Illinois Ubana-Champaign has developed a new and innovative ECMO training simulator to educate health care teams in performing this procedure. The task trainer is controlled by a software model of human physiology engine which can simulate various conditions during the ECMO procedure such as extreme hemodynamic instability and hypoxemia. The system provides immersive experiences such as pulsations and “blood” flow in the underlying vessels. The ECMO simulator has realistic, flexible vasculature to practice cannulation, and a blood substitute that changes color to simulate oxygenation. The ECMO training simulator is currently being used by the U.S. Air Force En route Care Research Center within the Department of Defense to train military medical personnel.
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