Interstate paediatric ECMO retrieval
Jenna McGeever / Wendy Bladwell / Killian O'Shaughnessy / Puneet Singh
NETS NSW, Kensington , Australia
Jenna is a clinical nurse specialist working at NETS and has and has worked as a retrieval nurse for the last 5 years. Prior to this Jenna worked in paediatric intensive care.
Over the last 40 years the Newborn and paediatric Emergency Transport Service (NETS) in NSW has developed a retreival service that provides safe and timely transportation of critically ill babies and children. NETS are now adding Extracorporeal Membrane Oxygenation (ECMO) retrievals to that well established base.
NETS NSW was requested to retrieval a 5 month old baby from a childrens hospital in Sydney to a Melbourne Children's hospital for heart transplant. This was the first NETS retrieval of an ECMO patient with central cannulation via a median sternotomy, making this a more challenging retrieval, with cannulas located only 2mm inside vessels.
This case presented multiple clinical and logistical challenges with the request being made of the New Years holiday period. The transfer was a sucess due to the effective collaboration of multiple parties. The team consisted of NETS retrieval nurses, a paediatric intensivist/NETS consultant and a clinical perfusionist.
The equipment required for this type of retrieval was not certified for this particular airframe, requiring approval from aeronautical engineers.
NETS obtained access to a FW aircraft that was chartered by the Royal Flying Doctors Service (RFDS).
In order to streamline processes for future ECMO retrievals, NETS are designing a system that incorporates ECMO equipment that will be certified as a unit. This will ensure induvidual devices will no longer require ad hoc certification.
Until NSW can offer heart transplantaion for children, ECMO retrievals to Melbourne for babies abd children requiring heart transplant will continue. The customised NETS ECMO system will be able to facilitate all future ECMO retrievals.