I have a question.  DOes anyone know if therer are currently any programs who use respiratory therapists as VAD, not ECMO, support personnel?  We have an institution that just started a pediatric VAD program, and the hoepital administrators want to use their current ECMO RRT's to help manage and run this program. They have attended a one day training on the device, and have done 2 implants in 3 months. Perfusion still helps to implant the device, and does some of the patient education.  However, the resp. people now want to do the troubleshooting, triage the patient and staff calls for alarms and troubleshooting of these devices.  Does anyone know of any laws or guidelines that prohibit or recommend againtst this practice?  Any information would be helpful  I feel this is a serious problem, both for these patinets, and for our profession.