Hospitals cope with shortage of nurses to run ECMO machines

Posted at 10:35 PM, Sep 15, 2021
and last updated 2021-09-16 12:10:58-04

NASHVILLE, Tenn. (WTVF) — ECMO machines are one of the many tools being used to fight against COVID in mid-state hospitals, and they're being used more than ever right now as the delta variant surges.

Last night we introduced you to a COVID survivor who says an ECMO machine helped save his life.

The machines are so in-demand, hospitals are running out of nurses to run them, forcing doctors to make tough decisions.

ECMO stands for extra-corporeal membrane oxygenation. For COVID patients admitted to the ICU, it's a machine that re-oxygenates your blood by pumping it outside your body, before pumping it back in, to give your lungs a rest.

St. Thomas West Nurse Jonathan Emling helps coordinate the ECMO machines at the hospital. They have about 20 machines, but only 10 are in use.

"Our problem is we don't have enough nurses trained on this machine to take care of the patient," Emling said.

But training new nurses is also a challenge. These machines work quickly -- cycling as much as one and a half gallons of blood through small tubes every minute. That requires care from nurses with specific and extensive training, who can know what to do if something goes wrong.

"The nurses who take care of this machine are the most experienced nurses in the hospital, and a good, experienced nurse is hard to find," Emling said.

But ECMO isn't an option for everyone.

Emling says in previous COVID waves, the focus was on ventilators because hospitals were filling up with more people who were older and couldn't be on ECMO.

But that's not the case anymore.

"This delta variant, everyone is younger, healthier and more baseline, so they're ideal ECMO candidates," Emling said. "So we simply don't have enough nurses or circuits to accept all of these patients."

And that's forced ECMO doctors to have to make some very difficult decisions.

"When you're choosing between a new 32-year-old mother and a 27-year-old, it's tough when you have one machine left to have to make those decisions in those age ranges of people," Emling said.

All this for a procedure where only about half of COVID patients on ECMO survive, and those who do have long-lasting health effects.

Brett Campbell, an ICU Physician at St. Thomas West agrees with Emling on the number of young people filling up their ICU beds during the latest delta wave.

"It's definitely been the hardest one just because it's a lot of young people, and they come in fast," Campbell said. "We have 10 people on ECMO consistently now, and there's a list of people waiting to get in."

Campbell says the ECMO treatment can be costly and can be avoided by getting a vaccination.

"I've seen people younger than me, healthy, with no co-morbidities, I've had to tell their wives they're going to be widows," Campbell said. "I've seen mothers deliver babies, and then succumb to the illness."

Campbell says he wishes he'd never have to give those talks but knows there are likely more to come, despite the availability of the COVID vaccine.

"It's just a lot of bad stuff, these are not memories I want," Campbell said. "These are things we could still prevent."

Full interview with ICU Physician Brett Campbell: