Mechanical CPR to ECMO to ROSC

[rock_shoes]

This is a new trial my service is initiating in conjunction with one of our major cardiac centres. Essentially the trial has set out some specific inclusion criteria that, if met, will include applying a mechanical CPR device and transporting to the ECMO capable emergency department. The most important piece within the inclusion criteria are that the patients will be prolonged VF/VT, relatively young, and of previous good health.

 

http://www.cbc.ca/news/canada/british-columbia/cardiac-arrests-survival-rate-1.3677885

 

http://www.metronews.ca/news/vancouver/2016/07/13/st-pauls-hospital-tests-lifesaving-heart-attack-treatment.html

[Off Label]

ECMO is a game changer. Time was that it was only really practical in the pediatric/ neonate population, but with technological advances adults now benefit as well. I've participated in two quite thrilling saves of patients who wouldn't have had a chance of survival at all. One was a young lady in her late 20's with a PE and the other was a 50 yo sudden death/ occult severe left coronary artery dz. 

[rock_shoes]

On 7/19/2016 at 11:45 AM, Off Label said:

ECMO is a game changer. Time was that it was only really practical in the pediatric/ neonate population, but with technological advances adults now benefit as well. I've participated in two quite thrilling saves of patients who wouldn't have had a chance of survival at all. One was a young lady in her late 20's with a PE and the other was a 50 yo sudden death/ occult severe left coronary artery dz. 

I certainly is. In the past, at least in my service, ECMO has been the occasional hail mary when the ALS provider felt it was worth trying to sell it to the Emerg department (usually fairly young, early CPR, prolonged VF/VT, maybe hypothermic). Even at that it required careful coordination to maintain quality CPR without a mechanical device. Good on those early pioneers for making the toss. I suspect the successes pushed this study into being.

[DartmouthDave]

Hello,

 

Very interesting.  In my region, as far I know, ECMO has not been used for out-of-hospital cardiac arrests.  

Off Label, in the case with the young women and the PE, did they try fibrinolysis first?

Cheers

[rock_shoes]

Dave are you working for Medavie back east now or in the great white north?

[DartmouthDave]

Hello,

I have been with Medavie for the past 5 years now.  Sometimes, I still miss the great white North.

K

[Off Label]

On ‎7‎/‎30‎/‎2016 at 9:09 AM, DartmouthDave said:

Hello,

 

Very interesting.  In my region, as far I know, ECMO has not been used for out-of-hospital cardiac arrests.  

Off Label, in the case with the young women and the PE, did they try fibrinolysis first?

Cheers

Negative...she came to us in full arrest.