Refractory V-Fib to cath lab follow up.

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.
 
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.
 
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
 
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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.
 
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.
 
I reckon prehospital ECMO is a better alternative than mechanical CPR...
 
A man can dream, right?
 
Summit said:
Wha?
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I can't imagine something like this happening in a US city.

1512201211494.jpg
 
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.
 
RocketMedic said:
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.
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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).
 
Summit said:
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).
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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.
 
RocketMedic said:
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.
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reeeeeeeeeeeeeee-bls-before-als.jpg


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?
 
EpiEMS said:
I can't imagine something like this happening in a US city.
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That is a sight. In a subway tunnel no less. Need three fire companies to move the patient.
 
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