Out‐of‐hospital extracorporeal membrane oxygenation cannulation for refractory ventricular fibrillation: A case report
Abstract Out‐of‐hospital cardiac arrest survival continues to be dismal with the only recent improvement being that of extracorporeal cardiopulmonary resuscitation (E‐CPR) or cardiopulmonary resuscitation (CPR), augmented by extracorporeal membrane oxygenation (ECMO). Minimizing time until initiatio...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-06-01
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| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.12033 |
| _version_ | 1811208227312893952 |
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| author | Jon Marinaro Sundeep Guliani Todd Dettmer Kimberly Pruett Doug Dixon Darren Braude |
| author_facet | Jon Marinaro Sundeep Guliani Todd Dettmer Kimberly Pruett Doug Dixon Darren Braude |
| author_sort | Jon Marinaro |
| collection | DOAJ |
| description | Abstract Out‐of‐hospital cardiac arrest survival continues to be dismal with the only recent improvement being that of extracorporeal cardiopulmonary resuscitation (E‐CPR) or cardiopulmonary resuscitation (CPR), augmented by extracorporeal membrane oxygenation (ECMO). Minimizing time until initiation of E‐CPR is critical to improve neurologically intact survival. Bringing E‐CPR to the patient rather than requiring transport to the emergency department may increase the number of patients eligible for E‐CPR and the chances for a good outcome. We developed a out‐of‐hospital E‐CPR (P‐ECMO) program that includes the novel use of a hand‐crank and emergency medical services (EMS) providers as first assistants. Here, we report the first P‐ECMO procedure in North America for refractory ventricular fibrillation involving a 65‐year‐old male patient who was cannulated in the field within the recommended 60‐minute low‐flow window and transported to our institution where he underwent coronary stenting. Details of program design and the procedure used may allow other systems to consider implementation of a P‐ECMO program. |
| first_indexed | 2024-04-12T04:17:39Z |
| format | Article |
| id | doaj.art-503f8e00053349aeb6fc1b9982cbf664 |
| institution | Directory Open Access Journal |
| issn | 2688-1152 |
| language | English |
| last_indexed | 2024-04-12T04:17:39Z |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj.art-503f8e00053349aeb6fc1b9982cbf6642022-12-22T03:48:20ZengWileyJournal of the American College of Emergency Physicians Open2688-11522020-06-011315315710.1002/emp2.12033Out‐of‐hospital extracorporeal membrane oxygenation cannulation for refractory ventricular fibrillation: A case reportJon Marinaro0Sundeep Guliani1Todd Dettmer2Kimberly Pruett3Doug Dixon4Darren Braude5Department of Emergency Medicine, Division of Prehospital Care University of New Mexico School of Medicine Albuquerque New MexicoDepartment of Emergency Medicine, Division of Prehospital Care University of New Mexico School of Medicine Albuquerque New MexicoDepartment of Emergency Medicine, Division of Prehospital Care University of New Mexico School of Medicine Albuquerque New MexicoDepartment of Emergency Medicine, Division of Prehospital Care University of New Mexico School of Medicine Albuquerque New MexicoDepartment of Emergency Medicine, Division of Prehospital Care University of New Mexico School of Medicine Albuquerque New MexicoDepartment of Emergency Medicine, Division of Prehospital Care University of New Mexico School of Medicine Albuquerque New MexicoAbstract Out‐of‐hospital cardiac arrest survival continues to be dismal with the only recent improvement being that of extracorporeal cardiopulmonary resuscitation (E‐CPR) or cardiopulmonary resuscitation (CPR), augmented by extracorporeal membrane oxygenation (ECMO). Minimizing time until initiation of E‐CPR is critical to improve neurologically intact survival. Bringing E‐CPR to the patient rather than requiring transport to the emergency department may increase the number of patients eligible for E‐CPR and the chances for a good outcome. We developed a out‐of‐hospital E‐CPR (P‐ECMO) program that includes the novel use of a hand‐crank and emergency medical services (EMS) providers as first assistants. Here, we report the first P‐ECMO procedure in North America for refractory ventricular fibrillation involving a 65‐year‐old male patient who was cannulated in the field within the recommended 60‐minute low‐flow window and transported to our institution where he underwent coronary stenting. Details of program design and the procedure used may allow other systems to consider implementation of a P‐ECMO program.https://doi.org/10.1002/emp2.12033cardiac arrestextracorporeal membrane oxygenationout‐of‐hospital |
| spellingShingle | Jon Marinaro Sundeep Guliani Todd Dettmer Kimberly Pruett Doug Dixon Darren Braude Out‐of‐hospital extracorporeal membrane oxygenation cannulation for refractory ventricular fibrillation: A case report Journal of the American College of Emergency Physicians Open cardiac arrest extracorporeal membrane oxygenation out‐of‐hospital |
| title | Out‐of‐hospital extracorporeal membrane oxygenation cannulation for refractory ventricular fibrillation: A case report |
| title_full | Out‐of‐hospital extracorporeal membrane oxygenation cannulation for refractory ventricular fibrillation: A case report |
| title_fullStr | Out‐of‐hospital extracorporeal membrane oxygenation cannulation for refractory ventricular fibrillation: A case report |
| title_full_unstemmed | Out‐of‐hospital extracorporeal membrane oxygenation cannulation for refractory ventricular fibrillation: A case report |
| title_short | Out‐of‐hospital extracorporeal membrane oxygenation cannulation for refractory ventricular fibrillation: A case report |
| title_sort | out of hospital extracorporeal membrane oxygenation cannulation for refractory ventricular fibrillation a case report |
| topic | cardiac arrest extracorporeal membrane oxygenation out‐of‐hospital |
| url | https://doi.org/10.1002/emp2.12033 |
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