Role of the emergency department in implementing an extracorporeal membrane oxygenation cardiopulmonary resuscitation

Felicity Gilbert; Gary Mitchell; Shane Townsend; Jayesh Dhanani; Nicole Sng

doi:10.1111/1742-6723.14100

Role of the emergency department in implementing an extracorporeal membrane oxygenation cardiopulmonary resuscitation

Emerg Med Australas. 2023 Feb;35(1):173-175. doi: 10.1111/1742-6723.14100. Epub 2022 Oct 10.

Authors

Felicity Gilbert^{1

2}, Gary Mitchell^{1

2

3}, Shane Townsend^{2

4}, Jayesh Dhanani^{4

5

6}, Nicole Sng^{1

2}

Affiliations

¹ Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
² Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
³ Jamieson Trauma Institute, Brisbane, Queensland, Australia.
⁴ Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
⁵ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
⁶ School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.

PMID: 36216499
DOI: 10.1111/1742-6723.14100

Abstract

The Royal Brisbane and Women's Hospital has introduced an extracorporeal membrane oxygenation (ECMO) cardiopulmonary resuscitation (E-CPR) service with collaboration between ED and ICU teams for refractory cardiac arrest patients. E-CPR is potentially beneficial to patients who do not gain return of spontaneous circulation after conventional advanced cardiac life support treatments, provided specific demographic and biochemical inclusion criteria are met. A joint ICU and ED decision is reached to commence ECMO flow. We discuss our rationale to use the ED and the emergency physician role in leading the multidisciplinary team, with ICU leading the cannulation team. The development of ED processes and the increased availability of this intervention can significantly impact the survivability of refractory cardiac arrest with good neurological outcomes.

Keywords: cardiac arrest; emergency medicine; extracorporeal membrane oxygenation.

MeSH terms

Cardiopulmonary Resuscitation*
Emergency Service, Hospital
Extracorporeal Membrane Oxygenation*
Female
Heart Arrest* / therapy
Humans
Out-of-Hospital Cardiac Arrest* / therapy