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South Carolina Board of Medical Examiners

Guidelines for Respiratory Care Practitioners Functioning as Extracorporeal Membrane Oxygenation (ECMO) Specialists

Approved by the Board:February 2-5, 2003 Board meeting

Service Area:Licensure, Respiratory Care Practitioners


In accordance with Section 1-23-40 of the 1976 Code of Laws of South Carolina, as amended, notice is hereby given that the State Board of Medical Examiners, on recommendation of the respiratory Care Committee, has adopted the following statement as guidance for respiratory care practitioners under the South Carolina Respiratory Care Practice Act (Section 40-47-500, et seq. of the 1976 amended Code).

Guidelines for Respiratory Care Practitioners Functioning as ECMO Specialists

Extracorporeal Membrane Oxygenation (ECMO) is a cardiopulmonary bypass technique used for the treatment of life threatening cardiac or respiratory failure applied for periods of greater than eight hours outside the operating room environment. ECMO Specialists are specially trained technical assistants who, under the direction of a licensed physician, manage the ECMO system (blood pump, tubing, artificial oxygenator, and related equipment, as well as pertinent maintenance and emergency procedures) and the clinical needs of the patient while on ECMO (such as maintenance of normal acid-base balance, oxygenation and ventilation, anti-coagulation) in ECMO Centers. ECMO centers generally follow the Extracorporeal Life Support Organization's document entitled Guidelines for Neonatal ECMO Centers, which details institutional and personnel requirements for ECMO programs.

The Board of Medical Examiners and Respiratory Care Committee recognize that the performance of tasks in ECMO centers or programs under the direction of licensed physicians is within the scope of professional practice for respiratory care practitioners, among other licensed professionals, provided that the individual licensed respiratory care practitioner is additionally qualified by special training and experience to perform assigned tasks as part of the ECMO team. Special training and experience include, at a minimum, (1) not less than two years of critical care experience (NICU or PICU preferred) while licensed as a respiratory care practitioner, (2) successful completion of an ECMO Specialist training course that is consistent with the Extracorporeal Life Support Organization's document entitled Guidelines for Training and Continuing Education of Neonatal ECMO Specialists (the ELSO Guidelines), and (3) documentation of competency to perform ECMO, including training and continuing education. It is presumed that each ECMO center will develop its own institution specific guidelines and policies for training ECMO Specialists, which may vary from the ELSO Guidelines to the extent appropriate for the individual ECMO center.

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