Occipital Offloading in the ECMO patient

Debora Bassy, MSN, CCRN, RN- Beaumont Health System, Royal Oak, Michigan

Background: Pressure injuries are one of the most underrated conditions in critically ill patients.  Many of these patients are hemodynamically unstable when they are turned.  Turning them can result in an cardiopulmonary resuscitative event.  Our unit noticed an increase in pressure injuries to the occipital area of our extracorporeal membrane oxygenation (ECMO) patient population.   ECMO is used for patients whose lungs and/or heart are failing who require maximal support where none of the traditional treatments have been effective.  Unfortunately some of these occipital pressure injuries have led to permanent loss or hair and poor body image.

Aim: Our aim was to trial a product that would successfully decrease the number of occipital pressure injuries in our ECMO patient population.

Methods: We chose to trial a fluid positioner specifically for this patient population.  It would be introduced to the patient upon ECMO cannulation and throughout their intensive care visit.  We opted for a minimal of ten patients over a six month period.

Findings: Three months into the trial we have noticed a significant decrease in occipital pressure injuries.

Evaluation: We plan to continue this trial to promote the reduction of occipital pressure injuries in the ECMO patient population.