Development and Implementation of a Comprehensive, Multidisciplinary Emergency Department Extracorporeal Membrane...

Area of Science:

• Cardiology
• Emergency Medicine
• Critical Care

Background:

• Over 350,000 annual out-of-hospital cardiac arrests (OHCA) in the US have a poor survival rate.
• Ventricular fibrillation/pulseless ventricular tachycardia (VF/VT) in OHCA suggests acute coronary ischemia but few patients stabilize for revascularization.
• Existing strategies for refractory cardiac arrest lack effective bridging to advanced interventions.

Purpose of the Study:

• To describe the development and initial experience of an emergency department (ED) extracorporeal membrane oxygenation (ECMO) program.
• To establish a multidisciplinary team for rapid ED ECMO deployment in OHCA patients.
• To improve neurologically favorable survival rates for OHCA patients requiring advanced circulatory support.

Main Methods:

• Expansion of existing ICU/perioperative ECMO services to the ED.
• Formation of a multidisciplinary team for rapid ECMO deployment.
• Case series and observational data collection on initial patient cohort.

Main Results:

• Demonstrated feasibility of rapid ED ECMO deployment for OHCA.
• Initial experience suggests potential for improved outcomes in selected OHCA patients.
• Established a template for other institutions to develop similar ED ECMO programs.

Conclusions:

• ED ECMO offers a viable strategy to bridge refractory OHCA patients to cardiac catheterization and revascularization.
• Multidisciplinary team approach is crucial for successful rapid deployment.
• This initiative aims to enhance survival and neurological recovery in OHCA patients.