EDECMO 45: ECMO in Sepsis

In this episode, Zack talks with Heidi Dalton about ECMO use in Sepsis.  This is another controversial area with pediatric literature showing strong results while the adult results have been less impressive.  Heidi has been a key figure in both adult and pediatric ECMO.  She is the former chair of the yearly ELSO conference.  She is a professor at both George Washington University and Virginia Commonwealth University.  Her background is in pediatric critical care. She currently works at INOVA in Virginia where she is the director of adult and pediatric ECMO. So the question for today is should we be utilizing ECMO for sepsis?

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EDECMO Crash Episode – Demetris Yannopoulos on ECPR-the Minneapolis Way

Yanno on ECPR

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Save These Dates!

EDECMO involved upcoming conferences: April 10-11: Mayo Scottsdale. April 25-28: The Society for Cardiovascular Angiography and Interventions. May 18-23: American Thoracic Society. AND SAVE THE DATE Reanimate 6 January 30th-Feb 1st, 2019. Sign ups will be opening up shortly  

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EDECMO 44: Bob Bartlett: Peristaltic Pumps, Hollow Fibers, and the History of ECMO

In this episode, Zack interviews Bob Bartlett from the University of Michigan.  He is truly the godfather of ECMO and has revolutionized the world with his leadership and innovation.  They discuss the history of ECMO and roller pumps and bubble oxygenators were clearly inferior to their current counterparts – centrifugal pumps and hollow fiber oxygenators.  They also discuss anticoagulation and how Bob feels direct thrombin inhibitors are superior.  They also discuss the future of ECMO and how peristaltic pumps may be where we are headed.  

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EDECMO 43: The Cutdown

In this episode,  Alice Hutin of the Paris SAMU talks about the modified cutdown approach to cannula insertion.  She is an emergency physician who is one of four physicians who take call on the pre-hospital ECMO ambulance.  She describes the process of their modified cutdown.  First, incision through the skin is made 2 cm below inguinal crease.  Second, blunt dissection down through the soft tissue.  This is best done with your fingers.  Third, place a needle through the distal skin and visualize it pass into the vessel.  From there, you cannulate as with percutaneous.  Alice’s recent paper shows a 6% failure rate with this technique in skilled hands.

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EDECMO 42: Organ Transplantation On ECMO

http://media.blubrry.com/edecmo/p/traffic.libsyn.com/edecmo/OG3_post_auphonic.mp3Podcast: Play in new window | Download (Duration: 32:07 — 26.2MB)Subscribe: Apple Podcasts | Android | RSS In this episode, we tackle the subject of organ transplantation on ECMO.  2017 featured several articles showing the efficacy of ECMO for organ transplantation.  In Italy, 56% of total potential patients were successfully transplanted.  The success of these […]

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EDECMO 41 – The 3 Stages of ECPR – Diane’s Story

In this episode Zack and Joe discuss the 3-stages of Extracorporeal Membrane Oxygenation (ECMO) – or put another way, this is how to start Extracorporeal Cardiopulmonary Resuscitation (ECPR) in the Emergency Department (ED). It’s been 4 years since we talked about these basic premises of ECPR. But this time, its highlighted in a very special story.

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EDECMO Episode 41 is REPOSTED

The original post for EDECMO 41 had to be permanently removed from the internet (for reasons beyond our control!!!) but its back. Click this link to take you to the new and improved (and HIPAA-compliant!!) episode: EDECMO 41 – The 3 stages of ECMO – Diane’s Story

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EDECMO 40: EROCA – The trial that asks “Should ER Docs Initiate ECPR?”

http://media.blubrry.com/edecmo/p/traffic.libsyn.com/edecmo/Take_3_Gunnerson.mp3Podcast: Play in new window | Download (Duration: 28:36 — 23.0MB)Subscribe: Apple Podcasts | Android | RSS   EROCA – University of Michigan – Gunnerson/Shinar Should Emergency Physicians initiate ECMO on arresting patients?  That is the question that Kyle Gunnerson from the University of Michigan (UMich) is asking with their new trial – EROCA.  UMich […]

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2016 ECMO CPT Codes, RVUs, and MediCare Reimbursement

Ok, so we just crashed an arrested patient onto ECMO and he is going to the cath lab. Now, how do I document the procedure again?  What was the CPT for percutanous cannulation for VA-ECMO?  Does my billing company even know? 

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