A 26-year-old Penn State student who was intoxicated decided not to drive and walk home in an area near Allentown, Pa. He fell, hit his head, went unconscious and into cardiac arrest. He was found frozen in the snow by his father, who called 9-1-1.
The responding paramedics initially felt he could not be resuscitated and called for the coroner. But a medical command physician, Dr. Gerald Coleman, felt that resuscitation should be attempted and asked the paramedics to perform CPR and get him the regional specialty care center at Lehigh Valley Hospital Cedar Crest. There, hospital staff continued to perform CPR for two hours as the young cardiac arrest patient was placed on extracorporeal membrane oxygenation (ECMO) so that his blood could be gradually warmed, oxygenated and re-circulated back into his body so his heart could be successfully restarted when the blood was back at a normal, acceptable level.
The procedure was successful and the young man survived with no neurological deficit.
The March 2016 issue of JEMS will focus on the new AHA Guidelines and detail how techniques such as ECMO will probably become more integrated into medical systems and need the understanding and support of prehospital providers and their medical directors to ensure that candidates for this advanced hospital treatment are taken to specialty centers that provide ECMO care.
The new AHA Guidelines restate that the use of extracorporeal cardiopulmonary resuscitation (venoarterial extracorporeal membrane oxygenation) as a rescue therapy for refractory cardiac arrest may be considered when the suspected etiology of the cardiac arrest is potentially reversible during a limited period of mechanical cardiorespiratory support. They also note that implementation of extracorporeal cardiopulmonary resuscitation is very resource-intensive and requires a highly coordinated system of care to be successful.
JEMS has been reporting on ECMO and the promise it has for patients for several years. Our March 2012 issue featured the compelling, personal story of paramedic Andrea “Dre” Dominguez and her amazing resuscitation by ECMO. Read these compelling articles and other forward-thinking articles featured in past issues of JEMS to see how this advanced level of care will perhaps be saving patients we thought could never be saved in the past.
Andrea Dominguez talks to her physicians Dr. David Willms (left) and Dr. Richard Sacks (middle).
ECMO & Mechanical CPR to be Featured at EMS Today
Attend the EMS Today Conference and Exposition in Baltimore, Feb. 25–27, to hear how ECMO is being used to resuscitate trauma patients at the Maryland Shock Trauma Center. You’ll learn how Dr. Joseph Ornato was saved by ECMO when he suffered a pulmonary embolism and how EMS systems are using mechanical compression devices for hours in some instances to allow patients to have consistently applied compressions as they await and undergo advanced clinical procedure like ECMO. EMS Today and JEMS present tomorrow’s care procedures to you today!
KEY EMS Today Conference Sessions on this topic
Don’t miss our upcoming webcast, Rise of the Machines: Mechanical CPR and What the Studies Don’t Tell You, taking place Wednesday, Jan. 27 at 1pm Central. Registration is free. Presenter Michael Levy, MD, of the Anchorage Fire Department will discuss how to determine if mechanical CPR is the right choice for your agency.DD