In a ten day period in January, Rega aircraft in Zurich, Switzerland transported and cared for a total of seven patients, including a two-year-old child, with the most severe cardiovascular and pulmonary disease.
This was made possible by a small, portable heart-lung extracorporeal membrane oxygenation (ECMO) machine, which is compatible with both the ambulance jets, and the two types of helicopters used by Rega.
Since 2009, Rega has been the only air rescue organization in Switzerland to have its own ECMO equipment. The devices have been instrumental in the care and transport of 25 intensive care patients annually. That’s close to 250 critical patients who have benefited from ECMO and the Rega system.
Cooperation with Swiss hospitals is a great example of what can be done with a mix of technology and EMS transportation resources. Rega transports around 2,000 people with cardiovascular problems per year aboard their rescue helicopters and ambulance jets.1
In the most severe cases, patients have benefited significantly from ECMO, which partially or completely takes over the respiratory and/or cardiac function of the patient.
Of the seven ECMO missions which took place in January, six were for patients transferred by Rega rescue helicopters from hospitals in peripheral areas to a center hospital. The seventh deployment involved moving one patient in a Rega ambulance jet from Switzerland to Germany.
The youngest patient was two years old. “Seven special transports with the ECMO in just ten days is an unusually high number,” says Roland Albrecht, chief physician of Rega. Thanks to the good cooperation between Rega and the cardiac surgery department of the University Hospitals in Zurich and Bern, as well as the medical intensive care unit of the Cantonal Hospital St. Gallen, we were able to carry out the assignments.”
Rega also maintains three midland and the mountain helicopters with completely different interior designs and layouts. The special medical equipment, such as the 15-kilogram ECMO device, must be used independently in all aircraft types. This required the specialists of Rega’s own development company to develop the required changes and adjustments to the aircraft, which were subsequently approved and recognized by the European Aviation Safety Agency (EASA).
ECMO is a proven resuscitation modality that was previously used only on premature infants. As more and more medical specialists and hospitals realize the role that ECMO can play in the resuscitation of adult patients, units have be moved from the pediatric/neonatal spaces in facilities to the ED, into EMS aircraft for interfacility transport to centers of resuscitation excellence. In Paris, a mobile ECMO program even brings it to street EMS with great efficacy.
Read more about ECMO and its emerging, expanded use in EMS, aeromedical, ED and hospital settings:
- Paramedic Saved by First-Time Use of ECMO Machine, by Carolyn Gain, EMT-P , A.J. Heightman, MPA, EMT-P
- Emergency Cardiopulmonary Bypass Creates Potential for Saving the Nearly Dead, by Jenn Liebman, MSL, RN, CFRN
- Young Man Saved by ECMO after Being Found Frozen, by A.J. Heightman, MPA, EMT-P
- ECMO & ECPR, by Sean Slack, DO, Hill Stoecklein, MD, Joseph E. Tonna, MD, FAAEM, & Scott T. Youngquist, MD, MS, FAEMS, FAHA
- ECMO & Refractory OHCA, by Demetris Yannopoulos, MD
- How Physicians Perform Prehospital ECMO on the Streets of Paris, by Alice Hutin, MD, MSc , Romain Corrocher, MD , Floriant Loosli, CRNA , Barbara Mantz, CRNA, Lionel Lamhaut, MD, PhD
- A Medical Director’s Personal Experience with ECMO Reveals Several Lessons Learned, by Joseph P. Ornato, MD, FACP, FACC, FACEP
References
1. Rega Center: Headquarters at Zurich Airport. (n.d.) Rega. Retrieved Feb. 1, 2018, from http://www.rega.ch/de/einsatz/einsatzbasen/rega-center.aspx
