Clinical Experience

Clinical Experience –tailored to fellow needs and interest

The fellowship’s clinical experience could include:

• 36 weeks of dedicated rounding and support service for ECMO, including time in CICU, PICU and NICU with opportunity to tailor this per trainee’s future career needs. 
  • 2 weeks with bedside specialists/core
  • 2 weeks with perfusion
• 6 weeks of dedicated rounding and consult service for CRRT.
• 6 weeks clinical service in the PICU and overnight call on average of 1 night per week
• 4 wks vacation

Clinical experiences are designed to

• Provide hands-on clinical experience and enhance proficiency in higher-level decision making as well as day-to-day management of neonatal and pediatric patients requiring ECMO.
• Collaborate with multidisciplinary teams to optimize patient outcomes.
• Learn operational and administrative considerations of directing an ECMO program
• Provide hands-on clinical experience and enhance proficiency in higher-level decision making as well as day-to-day management of neonatal and pediatric patients requiring CRRT/PLEX.
• Foster a culture of continuous improvement and professional development.
• Mentor residents and fellows in the management of extracorporeal support therapies.
• Learn hands on essentials of components and circuitry
• Track all high-risk patients, ECMO referrals and participate in candidacy discussion
• Participate in daily rounds and provide consultative services for ECMO
• Participate in daily rounds and provide consultative services for CRRT patients PICU and NICU
• Participate in PLEX runs in ICU settings with PLEX specialists

The ECMO fellow will be expected to perform common pediatric ICU procedures while on service in the PICU including: 

• Airway management including endotracheal intubation
• Central line placement (femoral/internal jugular)
• Arterial line placement (peripheral and femoral)
• Chest tube placement
• Procedural sedation/anesthesia

The ECMO Fellow will provide anesthesia/hemodynamic/respiratory support for patients during ECMO cannulation/decannulation under direct supervision by a PICU//NICU or anesthesia physician with appropriate anesthesia credentials through the hospital. 

The ECMO fellow will also learn about prescribing and managing CRRT and plasmapheresis, under the supervision of Nephrology and/or Hematology providers.