The ECMO coordinator is a senior ECMO specialist who, with the ECMO director, is responsible for developing and maintaining guidelines and standards for the multidisciplinary team. Their responsibilities also include the supervision, training, and assessment of the ECMO team.

ELSO defines the ECMO specialist as “the technical specialist trained to manage the ECMO system and the clinical needs of the patient on ECMO under the direction and supervision of an ECMO trained physician” (ELSO red book – Ref. [1]).

The ECMO specialist can come from a number of different clinical backgrounds, including nursing, perfusionists, and respiratory therapists. For the purpose of this chapter, only the training of nurses to achieve and maintain the qualification of ECMO specialist will be discussed.

The ECMO specialists are usually nurses with more than 2 years of experience at a senior level of working in an intensive care unit (ICU). They will have shown themselves to be able to work in stressful conditions, be decisive, and have excellent communication skills. The latter is of utmost importance, as they are central to all patient care and must maintain effective communication with not only the multidisciplinary clinical team but also the patient and his family.

Each center should have written guidelines and protocols defining the specific responsibilities of the ECMO specialist. These responsibilities will cover managing the extracorporeal circuit, including regular circuit surveillance, troubleshooting, accessing the circuit (e.g., CRRT), monitoring pre- and post-oxygenator gases to ensure optimal function, ensure cannula and circuit are safe during any mobilization or movement of the patient, and manage circuit emergencies. In some centers, the ECMO specialist’s role has expanded to include management of anticoagulation and weaning using defined guidelines. Such developments have improved the timeliness of interventions and thus improved patient care. The training of the ECMO specialist is built around providing them with the skills and knowledge to fulfill this role.