Description of Event or Problem · 0
PATIENT CAME TO CATH LAB FOR A (VENTRICULAR TACHYCARDIA) VT/(VENTRICULAR ECTOPIC) VF ARREST FOR INITIATION OF ECPR (EXTRACORPOREAL CARDIOPULMONARY RESUSCITATION). THE NOVALUNG DEVICE WAS PREPPED TO HAND UP TO THE STERILE FIELD TO START ECMO. WHEN HANDED UP THE P2 PRESSURE CABLE BROKE AND WOULD NOT LIGHT UP ON THE SCREEN. ATTEMPT TO PULL CORD AND SWITCH TO ANOTHER CABLE WAS MADE HOWEVER CABLE WAS STUCK IN DEVICE. WITH IN A FEW MINUTES OF ECMO(EXTRACORPOREAL MEMBRANE OXYGENATION) SUPPORT THE P3 PRESSURE CABLE ALSO WAS NO TRANSDUCING A PRESSURE AND IT WAS FOUND TO BE IN THE DISPOSABLE DEVICE OF THE NOVALUNG BUT NOT ABLE TO READ A PRESSURE. THIS CABLE ALSO REMAINED IN THE DEVICE. ECMO SUPPORT WAS NOT STOPPED DUE TO THE URGENCY OF NEED AT THAT TIME. THE PATIENT WAS HOOKED UP TO BLOOD PRESSURE AND EKG MONITORS TO ENSURE BEST CARE PRACTICES WERE FOLLOWED. ALSO, THE NOVALUNG WAS READING A TOTAL FLOW TO PATIENT WITH RPMS. OUR BEST PRACTICE IS TO INITIATE ECMO WITH FIO2 OF 50%, NO COLOR CHANGE WAS NOTED ON ARTERIAL LIMB OF CIRCUIT UNTIL THE OXYGEN LEVEL WAS INCREASED TO MAXIMUM SUPPORT OF 100% OXYGEN. UPON ARRIVAL TO ICU THE PATIENT'S PRESSURE CABLES WERE SWITCHED TO GAIN THE PRESSURES THAT WERE PREVIOUSLY NOT ABLE TO BE ACCESSED. ONCE CHANGED THE CLINICIANS WERE ABLE TO NOTE THE NEGATIVE PRESSURE WAS -400 MM HG. NORMAL IS LESS THAN -100 IDEALLY AROUND -50. THE OTHER ASTOUNDING THING WAS THE ECMO CIRCUIT DID NOT "CHUG" TO INDICATE IT WAS INDEED DRY OR NEEDING MORE FLUID FROM THE PATIENT. ULTIMATELY, THE PATIENT DEMISED WITHIN 5 HOURS OF ARRIVAL. SENT DISPOSABLE BACK TO FRESENIUS DUE TO OXYGENATOR NOT FUNCTIONING. LABS WERE DRAWN ON THE POST OXYGENATOR SIDE AT 100% FIO2 AND THE HIGHEST YIELD WAS A PO2 OF 87 MM HG. THE PATIENTS PO2 WAS 89 MM HG INDICATING THAT THE PATIENT'S NATIVE LUNGS WERE DOING THAT WORK AS IT WAS HIGHER THAN THE DEVICE SET IN PLACE.