Refractory V-Fib to cath lab follow up.

[cruiseforever]

A few months ago I made a post about the University of Minnesota treating pts. in refractory V-fib by placing them on ECMO and then to the cath. lab. Here is a paper that was recently published.


http://jaha.ahajournals.org/content/5/6/e003732.full

 

[MonkeyArrow]

A few months ago I made a post about the University of Minnesota treating pts. in refractory V-fib by placing them on ECMO and then to the cath. lab. Here is a paper that was recently published.


http://jaha.ahajournals.org/content/5/6/e003732.full

Your link is not linking to the paper.

 

[cprted]

Took my to an email login screen.

We just started a trial here for ECMO in refractory VF arrest. Definitely would be interested to read some of the results of your program.

 

[MonkeyArrow]

We're doing ECMO for refractory arrest but it's only happened a few times in the intra-arrest patient. More often than not, the CT team will elect not to place the patient on ECMO and we'll get ROSC after 30 minutes. Then, the patient will re-arrest in the cath lab during high risk PCI and that is when they'll canulate. Hoping to see more liberal use of ECMO in the intra-arrest patient in the near future.

 

[cruiseforever]

When I google this it comes to the paper.

Minnesota Resuscitation Consortium's Advanced Perfusion and Reperfusion Cardiac Life Support Strategy for Out‐of‐Hospital Refractory Ventricular Fibrillation

 

[MonkeyArrow]

Awesome study. Thanks for posting it. I will definitely sty to show it to our critical care cards team and ED team to improve our own ECMO practices.

 

[cruiseforever]

This is the latest update for the program that I have found. They have enrolled 90 pts. and have a success rate of 45%.

http://edecmo.org/edecmo-36-crushing-nihilism-cardiac-arrest-demetri-yannopoulos/

 

[VFlutter]

I am a huge proponent of ECMO however I am curious what advantage it has over Mechanical CPR + Intra-arrest PCI. Most of these patients have resolution of arrhythmias once the offending vessel is opened and many do not need mechanical circulatory post arrest. And I think current literature suggests IABP is more beneficial post PCI than ECMO.

 

[RocketMedic]

I reckon prehospital ECMO is a better alternative than mechanical CPR...

 

[Summit]

I reckon prehospital ECMO is a better alternative than mechanical CPR...

Wha?

 

[RocketMedic]

A man can dream, right?

 

[EpiEMS]

Wha?

I can't imagine something like this happening in a US city.

 

[RocketMedic]

Somewhere if that was American, there'd be at least three EMTs shrieking "BLS before ALS!" and someone complaining that they don't get paid enough to put in a central line, and a line of people denying the need for education.

 

[Summit]

Somewhere if that was American, there'd be at least three EMTs shrieking "BLS before ALS!" and someone complaining that they don't get paid enough to put in a central line, and a line of people denying the need for education.

No no... you see you can learn to do that in a 48 hour PHECMO certification class that includes 8 hours of clinical (no actual procedures required).

 

[cruiseforever]

A man can dream, right?

The same group that is doing the ECMO, is dreaming of one. They are planning on doing a study to see if it's possible.

http://www.startribune.com/universi...hasten-treatment-of-cardiac-arrest/453074973/

 

[NomadicMedic]

No no... you see you can learn to do that in a 48 hour PHECMO certification class that includes 8 hours of clinical (no actual procedures required).

You have to perform one cannulation of the Manikin. Your PHECMO card is valid for 2 years, after which you have to take a refresher. Taught by the same fake ACLS doctor.

 

[MonkeyArrow]

doctor

Doctor? Whoa, we have middle-of-the-road paramedics teaching ACLS round here parts.

 

[EpiEMS]

Somewhere if that was American, there'd be at least three EMTs shrieking "BLS before ALS!" and someone complaining that they don't get paid enough to put in a central line, and a line of people denying the need for education.

I will say, though, there is a valid complaint to be made here: What does it cost per QALY to have a team standing by to do ECMO on a subway platform?

 

[Tigger]

I can't imagine something like this happening in a US city.

That is a sight. In a subway tunnel no less. Need three fire companies to move the patient.