Episode 3 – Who the HELL do we put on ECMO during Arrest?

Who Gets ECPR and Who Doesn’t?

Great question! This may be the hardest question we deal with when a patient arrives and ECPR is a consideration.

This episode is broken down into three parts:

  1. Who exactly do we consider an appropriate candidate for ECPR?
  2. TOR = Termination of Resuscitation in the pre-hospital arena and why we HATE it!
  3. Pre-hospital ECPR – REALLY?

 

Episode 1 – An Introduction to ECMO Terminology

In this episode, Joe and Zack discuss some of the terminology and basics of ECMO and ECLS.

Terminology: (Synonyms)

  • ECMO = Extracorporeal Membrane Oxygenation
  • ECLS = Extracorporeal Life Support
  • CPS = Cardiopulmonary Support
  • ECPR (extracorporeal cardiopulmonary resuscitation)=ECLS initiation in the arresting patient

ECPR candidates:

  • STEMI with refractory VFIB
  • PE with shock or dysrythmia
  • Aortic Dissection
  • Massive OD
  • Pregnant with Amniotic fluid embolus
  • Hypothermia with temperature-dependent dysrythmia
  • Trauma

Future podcast episodes will drill down into the details of ECMO initiation, but in this episode Zack and Joe discuss Zack’s recent case where Zack did it all: managed the code…placed the cannulas…and initiated bypass, right there in the Emergency Department.