155: Use of a COVID-19 Protective ECMO Cannulation Guidelines for Cannulation of a Patient with Measles pARDS
Bibliographic record
Abstract
Introduction: Measles is one of the most highly communicable infectious diseases, requiring airborne precautions, and many regions have seen a resurgence in cases in recent years. During the COVID-19 pandemic, our institution developed a guideline for undertaking ECMO cannulations using protective measures, to reduce the risk of disease transmission and exposure to healthcare providers. Faced with a patient transferred with measles needing ECMO initiation, we report the application of these protective measures in the PICU. Methods: COVID-19 Protective ECMO cannulation guidelines were developed to provide guidance on the personnel, equipment, and individual protective equipment necessary to ensure the safety of the healthcare providers. These minimize the number of personnel in the room and maximize maintenance of the room’s negative pressure, thereby limiting exposure. It assigns roles to two teams: the cannulating team ‘inside the room’ and an ‘outside’ support team. The guideline is available via for review in a 7 min video, with voice over recording, to permit “Just-In-Time” pre-review or review via MSTeams ECLS Workspace Channel. Results: A patient with measles infection, bacterial toxic shock syndrome, and pARDS required cannulation to VA ECMO for cardio-respiratory failure. Airborne precautions were required. We deployed the COVID-19 Protective ECMO Cannulation guidelines. The patient was successfully centrally cannulated to VA ECMO using the protective cannulation approach with an inside and outside team. Conclusion: The COVID-19 Protective ECMO Cannulation guidelines were used for another infection requiring airborne precautions. We plan to continue to educate and apply protective cannulation guidelines for emerging airborne infectious diseases.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".