The purpose of this guideline is to provide a framework to support the Extra Corporeal Life Support (ECLS) team in the safe management of Extra Corporeal Membrane Oxygenation (ECMO) support in the event of power failure.
Background
The performance of all medical equipment is tested according to the standards within the tender agreement between the Trust and the manufacturer.
All ECMO equipment has comprehensive cover and is serviced routinely.
The multiprofessional team involved in the care of the ECLS patient should have an understanding of the physiology of ECLS, familiarity with the ECLS circuit and have reached a recognised level of competence in managing the ECLS patient and prepared to deal with any trouble shooting that may be required.
Note: While this guideline refers to the ‘child’ throughout, all activities are applicable to young people.
Centrimag
Both primary and back-up Centrimag consoles must be plugged into mains power at all times, including when not in patient use, to ensure internal batteries remain fully charged.
When in patient use
In the event of mains power loss, the Centrimag will automatically switch over to its internal battery. For reference, a new fully-charged internal battery will operate the console with a:
- Centrimag pump head and a flow of 5.5LPM/3500RPM for 60 minutes
- PediVAS pump head with a flow of 1.0LPM/3000RPM for 90 minutes (Levitronix 2008)
If mains power is unlikely to be restored within a short period of time (15mins) inform ECMO physician and Perfusionist/ECMO Coordinator.
Should a LOW BATTERY alert message be displayed on the console then immediate action is required to prevent the pump from stopping. Move to backup console which will provide a further period of battery operation. See guideline failure of primary console. Once procedure completed and flow re-established, replace the depleted console to maintain system backup.
Internal battery - the time which this will operate the console for is variable and so close attention must be paid to the battery charge LED indicator.
A final option in the event that mains power is not restored quickly, the Trust plans regarding evacuation to a safer area should be followed.
NB: Four external back-up battery systems are stored in the ECMO storeroom for use with the Berlin Heart/ECMO in instances of mains power failure. These may be used to prolong the length of time the patient can be supported on the primary Centrimag console. However should there be multiple ECMO/Berlin Heart systems affected by the power failure, then battery use must be carefully prioritised.
Document the incident in the medical and nursing notes and inform the ECMO coordinator. A critial incident form needs to be completed and sent to the ECMO office.
If the electrical power cannot be restored to the pump either by the mains or battery power, the perfusionist should be contacted to set up another circuit or assist with resolving the technical problem.
In summary, the Centrimag consoles must be plugged into the blue power sockets on the back of the 'ICU pillars' at all times. In event of mains power loss, that is the failure of external electricity and backup generators, there is at least an hour of backup power within the equipment.
Reference 1:
Levitronix (2008)
Centrimag Primary Console Operating Manual (VAS-ECMO). Waltham, Mass, Levitronix
Document control information
Lead authorMaura O'Callaghan, ECMO Co-ordinator, ECMO
Additional authorLiz Smith, Lead Nurse ANP, Cardiac ANP
Document owner
Maura O'Callaghan, ECMO Co-ordinator, ECMO
Approved byCho Ng, Lead Consultant ECMO, CICU/ECMO
First introduced: 5 July 1999
Date approved: 25 April 2012
Review schedule: Two years
Next review: 25 April 2014
Document version: 4.0
Replaces version: 3.0
