ELSO Adult ECMO Certification Exam

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A patient on ECMO develops significant bleeding from the cannulation site. Laboratory results show an aPTT of 120 seconds (goal 60-80s), hemoglobin of 7.0 g/dL, and platelets of 50,000/µL. Which of the following represents the most appropriate sequence of initial interventions?

Increase ECMO blood flow and administer protamine sulfate. Administer fresh frozen plasma (FFP) and request a surgical consult. Administer protamine sulfate and then transfuse platelets. Stop the heparin infusion, transfuse packed red blood cells and platelets.

Correct Answer:

Stop the heparin infusion, transfuse packed red blood cells and platelets.

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