Prehospital ECMO for Out-of-Hospital Cardiac Arrest

The new load & go destination for cardiac arrest? EMS providers know well the daily tragedies represented by the following three cases, where young or otherwise healthy individuals succumb to sudden and unexpected illness or injury. Although prehospital personnel make remarkable saves, many previously healthy patients die of medically reversible causes, despite excellent prehospital care, simply because standard resuscitative practice can't provide sufficient cardiopulmonary support during severe derangements of heart and/or lung function to allow time for recovery or definitive treatment of the immediate cause. Case I: Witnessed Out-of-Hospital Cardiac Arrest Your crew responds to the scene of a 55-year-old male who was witnessed to collapse while walking in the park with his wife. Bystanders immediately started chest compressions and called 9-1-1. On arrival, the patient has been pulseless for nearly 10 minutes. While performing high-quality chest compressions, you place the patient on the monitor and note an initial rhythm of ventricular fibrillation (v fib). An initial shock of 120 J produces a transient organized rhythm before v fib recurs. Two subsequent shocks are administered along with a bolus dose of amiodarone. The patient then develops a rhythm indicating idioventricular pulseless electrical activity (PEA). A definitive airway is established by your partner and after 45 minutes of field efforts, the patient is still in PEA. You call online medical control reg...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Patient Care Cardiac & Resuscitation Source Type: news