Recently, the ECMO team experienced one of those worst-case scenario situations, as we had an actively coding COVID-positive patient whom the PICU attending physician was attempting to get consent for ECMO initiation from the patient’s father via phone. The father was actually hospitalized with COVID and the mother is in the ICU at another hospital on a ventilator with COVID. The father’s primary language was Spanish and these family members were Jehovah's Witnesses.

I was kind of late walking into the situation as I was called in from home at 1:45 am this morning. I wanted to reach out to say that Tracy Harris did a phenomenal job as the House Supervisor. She was fast and efficient as she made many phone calls per the request of the PICU attending physician in an attempt to get an emergency court order to approve blood product utilization that is necessary for ECMO. She also contacted one of the physicians in the ER who is Spanish speaking and had him translate and contact the father of this patient several times to make sure he understood that blood product refusal for this child meant ECMO is not a feasible option and without ECMO initiation that his son was going to pass away.

In the meantime, she called in a Spanish interpreter for utilization but Tracy was quick to think of an alternative translator in the intense, very time-sensitive moment. Tracy was able to get the PICU attending physician in contact with risk management and one of our legal advisors/attorney at 3:00 am so that we could discuss the urgency of this matter and the dire need for an emergency court order if we were to have any chance of saving this child’s life. Despite risk management and legal agreeing to immediately contact the district attorney in an attempt to proceed with the emergency court order, the patient was not able to be supported for a prolonged amount of time while we waited for the approval and he passed away.

Tracy then advocated on the behalf of the patient and went on to seek approval for the patient’s sister to come to visit him before his body was removed from the unit (the sister was over 18 years of age). This was hands down one of the most difficult, mentally, and emotionally draining situations I have been in for an attempted ECMO initiation. I just wanted to send praises for Tracy’s resilience, support, and efficiency during this entire situation. She demonstrated amazing leadership and compassion. I am so thankful she was there to help in a very stressful and time-sensitive situation. Tracy, you are an extraordinary nurse and an inspiration to us all! Congratulations, you make us proud!