2amccm.com Critical Care & Cardiology Education

ECMO Rounding Checklist

VA & VV — Circuit parameters, TMLR, anticoagulation, cannulae exam, note generator

Type

Circuit

Cannulae

Clinical

Note

Step 1 — Patient & ECMO type

Patient name or N/A

MRN or N/A

ECMO configuration

Select the configuration before proceeding — controls which fields appear downstream.

Step 2 — Circuit parameters · VA ECMO

Flow L/min

RPM

Sweep L/min

FdO2 %

SvO2 %

Pressures

P1 mmHg

Pre-pump

P2 pre mmHg

Pre-oxygenator

P2 post mmHg

Post-oxygenator

Transmembrane pressure gradient

(P2 pre − P2 post) ÷ Flow

—

mmHg / (L/min)

Enter values

Step 3 — Anticoagulation

AC status

aPTT goal

Goal range (sec)

Reason held

Specify

Step 4 — Cannulae & circuit exam

Return cannula (arterial)

← select side

Dressing intact No bleeding, no expanding hematoma

cm marking

Abnormal finding at site

Limb perfusion — cannulated leg

Pulses of the foot and leg palpable Doppler signals of the foot and leg detectable No signs of limb ischemia — warm, no mottling, cap refill intact

Signs of limb ischemia present

Drainage cannula (venous)

← select side

Dressing intact No bleeding, no expanding hematoma

cm marking

Abnormal finding at site

Distal perfusion cannula · VA only side: —

No bleeding at site

Abnormal finding at site

Circuit inspection

No visible clot in tubing, pump head, or oxygenator Connections secure — no kink or circuit compromise

Step 5 — Hemodynamics & vent strategy

Pulsatility

Assessed from arterial line waveform pulse pressure

Oxygenation improving / on target Native ventilator settings reviewed

Vent strategy

Plan — select all that apply

Continue daily checks — no changes at this time, will continue to follow Monitor above issues — follow closely Circuit exchange recommended Oxygenator exchange recommended Vent strategy needed

Other

Step 6 — Note · copy to Epic

For clinical use by qualified physicians only. Not a substitute for direct assessment.
2amccm.com · Dr. Jesse Shriki DO, MS, FACEP

2amccm.com · Critical Care & Cardiology Education · Dr. Jesse Shriki DO, MS, FACEP