Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) is initiated as a rescue strategy during cardiac arrest when conventional measures do not result in return of spontaneous circulation. Nurses are frequently the first responders to acutely deteriorating patients in the ICU and are crucial to the success and efficiency of a bedside ECPR event. We developed a nurse-led, high fidelity in-situ pediatric ECPR simulation training program at our pediatric cardiac intensive care unit (PCICU). Methods: ECPR simulations were performed every 3-6 months from 2021 to 2025 in the PCICU led by 1-3 clinical nurse leaders. In addition to nursing participants, other members of the PCICU team including cardiac surgeons, perfusionists, respiratory therapists, support technicians, advanced practice providers, fellow and attending physicians also participated. All nursing participants completed 1 hour of pre-simulation online modules prior to attendance. Surveys with questions on a likert-based scale were administered to nursing participants immediately prior and after the ECPR simulation. Time from CPR to ECMO cannulation from real patients were collected from 2021-2024 during the training period. Results: Over a period of four years, a total of 126 nurses participated in 11 simulations. Compared to pre-intervention likert-scores on self-rated knowledge of ECPR protocol and procedures, comfortability with setting up/preparing for ECMO cannulation, and satisfaction with interdisciplinary team work, immediate post-simulation scores were significantly higher in all categories mentioned above (p < 0.05). For in-unit ECPR activations for patients, the average duration from CPR to ECMO cannulation decreased during the simulation training period (50 minutes in 2021 vs 35 minutes in 2024). Conclusions: Our study demonstrated feasibility and effectiveness of a nurse-led multidisciplinary pediatric ECPR simulation program. High-fidelity multidisciplinary ECPR simulations significantly improved nursing confidence with the ECPR protocol and procedures, preparation for ECPR, and satisfaction with working in a team. CPR to ECMO times during in-unit ECPR activations decreased during the study period.
Williams et al. (Sun,) studied this question.
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