In which step of ECMO insertion do you prepare the circuit?

Preparing the circuit is an essential step in the ECMO procedure, as it ensures that the system is ready to support the patient’s cardiac and respiratory functions. This phase involves assembling the ECMO components, including the oxygenator, blood pump, tubing, and additional accessories, and then priming the circuit with a suitable fluid, typically saline or an appropriate heparinized solution, to remove air bubbles that could cause emboli.

This step is critical because any air in the circuit can lead to serious complications once ECMO is initiated. Additionally, pre-priming allows for the assessment of the system for leaks or malfunctions before connecting it to the patient, ensuring that when ECMO therapy begins, the circuit is fully prepared to oxygenate and circulate the patient’s blood effectively.

While other steps in the ECMO process, such as assisting with cannula placement or notifying the bedside nurse, are important, they do not involve the actual preparation of the circuit itself. Initiating ECMO therapy remains dependent upon having a properly prepared and functioning circuit, highlighting the importance of this step in the overall ECMO management process.