ECMO Rounding Checklist

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 %

Goal >65% (VA)

Pressures

P1 mmHg

Pre-pump (negative)

P2 pre mmHg

Pre-oxygenator

P2 post mmHg

Post-oxygenator

PaO2 post mmHg

Post-oxygenator (optional)

Transmembrane ΔP (raw)

P2 pre − P2 post

—

mmHg

Enter values

Transmembrane lung resistance (TMLR)

(P2 pre − P2 post) ÷ Flow

—

mmHg / (L/min)

Enter values

ΔP and TMLR bands are an institutional teaching heuristic, not literature-derived; the evidence-based approach is trending from a device-specific baseline rather than fixed cutoffs. Oxygenator-dysfunction monitoring reference: Vasques et al. ASAIO Journal. 2023;69(9):849–855. PMID: 37159512.

Step 3 — Anticoagulation

AC status

Step 4 — Cannulae & circuit exam

Return cannula (arterial)

Fr

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)

Fr

Dressing intact No bleeding, no expanding hematoma

cm marking

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

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