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?
[Read more]EDECMO 39: Who Do We Put On ECMO? – New Data on Prognostics
Posted on October 6, 2017 // 2 Comments
In this episode Zack interviews the first authors of the three biggest papers this year dealing with the question of “Who should I put on ECMO?” Guillaume Debaty of Grenoble, France published a paper outlining what prognostic factors are important. Guillaume’s data shows importance of short low times, lower lactates and higher pH values. The real question is what number for each of these should we consider a hard stop on initiation. This is followed up by Josh Reynolds who along with Ben Singer out of the UK published a paper utilizing cardiac arrest data from the PRIMED trial. He showed that even patients with all the advantageous characteristics of traditional ECMO inclusion criteria had poor survivals once they have had >30 minutes of chest compressions. With many ECMO studies having average arrest to
initiation times of > 60 minutes, Josh’s paper certainly makes us view favorably the 30% survival outcomes that we are seeing worldwide. This in no way substitutes for a randomized trial but does offer some guidance on what the expected survival of a patient with a witnessed arrest, short low flow times, and age < 65. We conclude with Nate Haas out of the University of Michigan who utilitzed the ELSO database to show that age was not predictive of survival. This may push us towards including older patients in our inclusion criteria, but more data is definitely needed on this.
[Read more]REANIMATE 4 Mashup Video!
Posted on September 24, 2017 // 1 Comment
REANIMATE 4 was THE best conference event I’ve ever had the pleasure to be associated with! Take a look at this short video mashup of the entire event (and thanks to Jeremy Haywood, our videographer, video editor, and video producer)
For those of you who attended, thank you for bringing your “A-Game”! Ya’ll came prepared and motivated! Your energy and devotion has completely re-energized us! It was a little bittersweet when we all had to part ways on Friday. But welcome to the REANIMATE family!
If you couldn’t make it to “R4”, now’s the time to register for REANIMATE 5, which will be March 8-9, 2018 in San Diego.
[Read more]Crash Episode: Iowa OHCA ECMO Save – with Andrew Karl Terry
Posted on September 7, 2017 // 5 Comments
Mini episode – This is a great example of where a little persistence with your colleagues can help save someone’s life. Dr. Andrew Karl Terry, having had only limited exposure to ECMO, was able to encourage his Cardiologists to put a witnessed VF patient on ECMO. The rest is history!
[Read more]EDECMO 38 – ECMO and Trauma – with Pal Ager-Wick and Magnus Larsson
Posted on August 27, 2017 // 2 Comments
This episode is all about ECMO in trauma – not the usual ARDS, TRALI VV-ECMO – we’re talking about VA ECMO for the acutely dying trauma patient. Zack interviews Pål Ager-Wick from Tromso Norway, and Magnus Larsson from the Karolinska Institute in Stockholm. We talk about everything from how ECMO helps the hemorrhaging trauma patient to the futuristic “Emergency Preservation and Resuscitation” concept being done in Baltimore now.
[Read more]REANIMATE 5: March 8-9, 2018
Posted on August 1, 2017 // Leave a Comment
REANIMATE 5 will be on March 8-9, 2018 in San Diego, California.
Registration will open on September 21, 2017. Announcements will precede! But if you want to guarantee a spot at R5, put yourself on the Reanimate 5 Pre-Reg list. REANIMATE sells out quickly. People are always asking how to guarantee their spot. This is the ‘ticket’!!!
ECMO, ECPR, REBOA, TEE, & Bleeding-Edge Resuscitation
Special Guest Faculty Member: Resuscitationist and interventional cardiologist Demetris Yannopoulos from the University of Minnesota. For more on Demetris’ recent contributions to ECPR:
EDECMO 36 – Crushing the Nihilism of Cardiac Arrest – with Demetris Yannopoulos
Crash Episode – MicroDissection of Yannopoulos’ ECMO Method
For more information on the Conference: reanimateconference.com
[Read more]EDECMO 37 – Nate’s Story
Posted on July 21, 2017 // 1 Comment
Jake is an Emergency Physician from Santa Cruz California whose interest in resuscitation was put to the fullest test when his own son had a cardiac arrest. This is the amazing retelling of that day in November when what Jake learned in an EDECMO workshop was utilized in a dramatic fashion. This is a story of two heros: Jake and his son Nate.
[Read more]Haney Mallemat Endorses REANIMATE 4!
Posted on July 19, 2017 // Leave a Comment
At Castlefest/Resusfest 2017 I caught up with Dr. Haney Mallemat and asked him to opine on our upcoming REANIMATE 4 conference on September 21-22, 2017. Haney did not disappoint! Check it out:
[Read more]Crash Episode – MicroDissection of Yannopoulos’ ECMO Method
Posted on July 15, 2017 // 1 Comment
EDECMO 36 – Crushing the Nihilism of Cardiac Arrest – with Demetris Yannopoulos
Posted on June 9, 2017 // Leave a Comment
In this podcast episode, Zack interviews Demetri Yannopoulos from the University of Minnesota. Demetri has organized Minneapolis into arguably the most impressive ECPR city in the world. He has changed the mindset of out of hospital refractory ventricular fibrillation care from “stay and play”, the philosophy that medics should stay at the scene and provide care until ROSC (return of spontaneous circulation) or until the patient is pronounced dead. In Minneapolis, a patient who who arrests in Yannopoulos’ catchment area gets three shocks. If the patient does not get ROSC then they are immediately transported to the University of Minnesota using LUCAS mechanical chest compression device. The patient bypasses the emergency department and goes directly to the cath lab. In the cath lab, Demetri, or one of his partners, cannulates and initiates ECMO with an average time of 6 minutes!!! In his first 90 patients he has had a 45% neurologically intact survivorship. Patients are getting to the cath lab on average 60 minutes after their arrest. In this cohort, you would expect a less than 1% survival. We can use Dr. Yannopoulos’ model to expand the use of ECPR in many other systems. The real question is do we have champions like Demetri who will rise to the calling!
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