Expert consensus on training and accreditation for extracorporeal cardiopulmonary resuscitation an international, multidisciplinary modified Delphi Study

. 2023 Nov ; 192 () : 109989. [epub] 20231005

Jazyk angličtina Země Irsko Médium print-electronic

Typ dokumentu časopisecké články, práce podpořená grantem

Perzistentní odkaz   https://www.medvik.cz/link/pmid37805061

BACKGROUND: A multidisciplinary group of stakeholders were used to identify: (1) the core competencies of a training program required to perform in-hospital ECPR initiation (2) additional competencies required to perform pre-hospital ECPR initiation and; (3) the optimal training method and maintenance protocol for delivering an ECPR program. METHODS: A modified Delphi process was undertaken utilising two web based survey rounds and one virtual meeting. Experts rated the importance of different aspects of ECPR training, competency and governance on a 9-point Likert scale. A diverse, representative group was targeted. Consensus was achieved when greater than 70% respondents rated a domain as critical (> or = 7 on the 9 point Likert scale). RESULTS: 35 international ECPR experts from 9 countries formed the expert panel, with a median number of 14 years of ECMO practice (interquartile range 11-38). Participant response rates were 97% (survey round one), 63% (virtual meeting) and 100% (survey round two). After the second round of the survey, 47 consensus statements were formed outlining a core set of competencies required for ECPR provision. We identified key elements required to safely train and perform ECPR including skill pre-requisites, surrogate skill identification, the importance of competency-based assessment over volume of practice and competency requirements for successful ECPR practice and skill maintenance. CONCLUSIONS: We present a series of core competencies, training requirements and ongoing governance protocols to guide safe ECPR implementation. These findings can be used to develop training syllabus and guide minimum standards for competency as the growth of ECPR practitioners continues.

Alfred Health Melbourne Victoria Australia

Assistance Publique Hôpitaux de Paris Paris France

Chair EuroELSO Working Group on ECPR Deputy Head 2 Dept of Internal Medicine Cardiovascular Medicine U Nemocnice 2 Prague 2 128 00 Czech Republic

Charité Universitätsmedizin Berlin Germany

Department of Perioperative Medicine Westmead Hospital Hawksbury Rd Westmead NSW 2145 Australia

Director of Emergency and Critical Care Services Lin Shin Hospital Taichung Taiwan

Division of Prehospital Austere and Disaster Medicine NM United States

Erasmus MC University Medical Center Netherlands

Guy's and St Thomas' NHS Foundation Trust London UK

Hyogo Emergency Medical Center Kobe Japan

Korea University Anam Hospital Seoul Republic of Korea

Monash University Australia

Monash University Victorian Heart Hospital Australia

National Taiwan University Hospital Taipei Taiwan

Portland OR USA

Royal Papworth Hospital Cambridge UK

Royal Papworth NHS Foundation Trust Cambridge Biomedical Campus l Cambridge UK

Royal Prince Alfred Hospital Australia

Royal Prince Alfred Hospital Faculty of Medicine and Health University of Sydney Australia

RPAH and Sydney University Medical School Australia

Sharp Memorial Hospital San Diego CA USA

St Bartholomew's Hospital London UK

St Bartholomew's Hospital London UK London's Air Ambulance London UK

St Luke's International Hospital Tokyo Japan

St Vincent's Hospital Sydney Australia

The Alfred Hospital Melbourne Victoria Australia

The Alfred Hospital Victoria Australia

The Alfred Hosptial Victoria Australia

The Prince Charles Hospital Brisbane QLD Australia

University Hospital Birmingham UK

University Hospital Regensburg Germany

University of Minnesota Medical School USA

Utrecht The Netherlands

Westmead Hospital Sydney Australia

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