• Lillian Su, Michael C Spaeder, Melissa B Jones, Pranava Sinha, Dilip S Nath, Parag N Jain, John T Berger, Lisa Williams, and Venkat Shankar.
• 1Division of Critical Care Medicine, Children's National Health System, Washington, DC. 2Division of Cardiovascular Surgery, Children's National Health System, Washington, DC. 3Division of Critical Care Medicine and Cardiology, Children's National Health System, Washington, DC. 4Children's National Heart Institute, Children's National Health System, Washington, DC.
• Pediatr Crit Care Me. 2014 Nov 1; 15 (9): 856-60.

ObjectiveTo determine if development of an extracorporeal cardiopulmonary resuscitation simulation program reduced extracorporeal cardiopulmonary resuscitation times in real patientsDesign: Before-after study.SettingTwenty-six bed pediatric cardiac ICU in a tertiary urban hospital.PatientsForty-three cardiac patients (aged 1 d to 16 yr) who received extracorporeal cardiopulmonary resuscitation.InterventionsAn interdisciplinary team collaborated to define the roles and clarify responsibilities of each individual involved in extracorporeal cardiopulmonary resuscitation. An "ideal rapid deployment" was defined and tested using simulation sessions. This included a task analysis, role creation, and multidisciplinary simulations, including structured debriefings and video review and the creation of a master checklist.Measurements And Main ResultsThere were a total of 43 episodes of extracorporeal cardiopulmonary resuscitation during the study period, 16 (37%) of which occurred during the preintervention time period (from February 2009 to March 2010) and 27 (63%) during the postintervention time period (April 2010 to March 2013). The median deployment time in the preintervention time period was 51 minutes (interquartile range, 43-62 min), whereas the median deployment time in the postintervention time period was 40 minutes (interquartile range, 23-52 min) (p = 0.018).ConclusionsThere are no standard guidelines of how a team should coordinate the efforts of nursing, physicians, extracorporeal membrane oxygenation specialists, surgeons, respiratory therapists, patient care technicians, and unit clerks to emergently execute this complex procedure. Because time is of the essence, it is essential to develop a highly functioning and well-coordinated team with a standardized method of the procedure, its documentation, and communication. Simulation accomplished this for our program. Following these simulation exercises, not only was there a subjectively observed improved coordination and smoother deployment of extracorporeal membrane oxygenation in real-life extracorporeal cardiopulmonary resuscitation, but we have also demonstrated a significantly faster deployment of extracorporeal membrane oxygenation as compared with the presimulation era.

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