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SUMMARY Provides clinical patient care assessment, initiation, modifications and weaning of Extracorporeal Membrane Oxygenation (ECMO), also referred to as Extracorporeal Life Support (ECLS), to neonatal, pediatric and adult patient populations at Rhode Island Hospital and Hasbro Children's in collaboration with a licensed physician with expertise in ECMO. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done.

The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES Evaluates, assesses and performs prescribed clinical procedures and therapy by order of a licensed medical provider. Works under the general supervision of the ECMO Manager, Respiratory Clinical Supervisors and Managers of the Respiratory Care Dept. Analyzes and evaluates clinical patient data to determine the appropriate therapy or intervention and offers recommendations on patient care to the medical staff.

Modifies therapy, as appropriate, based on patient physiology and response by executing the knowledge of understanding the indications, contraindications and the safe and effective use of all hospital approved pharmacological agents and blood products delivered through the ECMO system. May accept verbal orders from a physician, nurse practitioners and/or physician's assistant where appropriate. Assists the physician in the initiation of ECMO.

Assembles, primes and evaluates the acid/base status of the ECMO circuit prior to the start of ECMO. Analyzes and evaluates clinical patient data to determine appropriate adjustments to the ECMO system and maintain prescribed parameters for acid-base balance, anticoagulation, circuit pressures, platelets, hematocrit and temperature. Participates in bedside rounds to review, discuss and recommend preferred treatment methods for patients.

Responsible for initiation, delivery and discontinuation of all medications and blood products delivered through the ECMO system. Monitors, evaluates and adjusts anticoagulation therapy under direction of the physician. Coordinates and accompanies ECMO patients while on intra and inter hospital transport.

Continuously monitors, assesses and evaluates patients on ECMO to maintain safety. Responsible for maintaining up to two ECMO patients simultaneously. Provides clinical instruction on the proper use of ECMO equipment, related procedures and management to other health care providers.

Evaluates, assesses, monitors, maintains and troubleshoots equipment used for the delivery of ECMO. Maintains and ensures the availability and functionality of a standby ECMO circuit and all emergency ECMO equipment at the bedside for any circuit emergency. Participates in all comprehensive in-house orientation and competency training in ECMO and related procedures.

When not functioning as an ECMO Specialist, functions as a staff respiratory therapist, evaluating and assessing the clinical appropriateness, efficacy and responses to basic and medically complex respiratory care procedures in patients with cardiopulmonary related difficulties. Assesses, evaluates and provides complex intensive respiratory care and mechanical ventilation in all patient populations within the acute intensive care areas. Provides safe and effective service to the Code Response Team, Rapid Response/Fast Team, and the high risk transport of ECMO patients to/from outlying facilities (LifePact).

Provides expert care in the use of high frequency ventilation, bronchoscopy assistance, percutaneous tracheostomy procedures, nitric oxide delivery, heliox or other medical gas delivery. Participates in approved IRB medical research projects. Cleans and restocks pump and equipment cart after discontinuation of ECMO support following all hospital policies regarding infection control and bio-hazard waste procedures when caring for and disposing of circuit components.

Assembles all components, monitors, evaluates and assesses the SCUF to ECMO interface. Participates in departmental quality improvement activities including documenting variances which occur during the administration of ECMO. Attends ECMO Staff Meetings for case peer review and in-service education.

Provides in-service education for other health care professionals. Performs periodic practice primes, wet drills and simulation activities. Records pertinent data on flow sheets/EMR and writes shift notes.

Safeguards the privacy of all patients and protects the confidentiality of their health information. PROFESSIONAL DEVELOPMENT Maintains and updates clinical knowledge and skills based on current ECMO and respiratory care education practices. Adheres to requirements for all mandatory training and competencies, both departmental and system.

Identifies specific learning needs/goals and develops a plan to meet them. Contributes to relevant committees, professional meetings, continuing education and/or formal academic programs. Must participate in ECMO coverage on-call scheduling.

Participation in routine ECMO competencies and drill, I-Stat recertification. MINIMUM QUALIFICATIONS QUALIFICATIONS Active Rhode Island Respiratory Therapy state license. Registered by the National Board for Respiratory Care within 6 months of hire.

Associates degree in Applied Science in Respiratory Therapy (Bachelors preferred). One year of critical care experience in respiratory care and mechanical ventilation in all age groups. Successful completion of the RIH Respiratory Care Department ECMO training course.

SKILLS/ABILITIES/COMPETENCIES REQUIRED Must maintain current and active BLS, PALS and ACLS certification. (PALS, ACLS within 6 months). The only acceptable BLS or other life support certifications will be from the American Heart Association.

Proficiency in advanced respiratory care practices in all age groups. Knowledge of care and administration of blood and blood products. Ability to train, orient and mentor new ECMO staff members.

Must maintain minimum pump hours per year (80). Will function as Alternate Supervisor and/or ECMO backup as assigned. Pay Range $37.57-$61.45 Location Rhode Island Hospital - 593 Eddy Street Providence, Rhode Island 02903 Work Type 7 PM to 7:30 AM, every other weekend and every other holiday Work Shift Night Driving Required No Union United Nurses And Allied Professionals Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment

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