EMS partners with UW to combat cardiac arrest

MADISON, Wis. — Dane County Emergency Management participated in a simulation training with UW Health on Tuesday meant to save more out-of-hospital cardiac arrest patients. 

EMS providers were trained on how to identify in the field if a patient is eligible for extracorporeal membrane oxygenation, a life support technology known as ECMO.

UW Health Assistant Professor of Emergency Medicine Dr. Josh Glazer said for some patients this partnership can be the difference between life and death. 

“If you’re a victim of sudden out-of-hospital cardiac arrest your chances of neurological intact survival, that is going home to your family the same patient you were before arrest is roughly 400 percent higher than the national average,” said Glazer.

EMS providers and doctors will have a one hour window to identify if a patient meets the criteria for ECMO, transport them to UW Hospital, and get the patient on support, all while maintaining compressions.

Fitchrona EMS Chief Patrick Anderson said this partnership will benefit people in Madison, Verona and Fitchburg the most.

“As you can imagine farther out in Dane County and other agencies it’s physically or geographically impossible to get them to an ECMO center within that sixty minutes,” he said.

The machine works by temporarily replacing the function of the heart and lungs giving doctors time to determine and fix the underlying problem–the reason the patient went into cardiac arrest in the first place.

UW Health doctors said ECMO circuits have been used to treat heart and lung failure, heart and lung disease and transplant of those organs for over a decade at UW Hospital.

This program with EMS will allow them to expand the scope of patients who can benefit from the technology by providing emergency department doctors more time to assemble the teams and tools necessary to get a patient on ECMO support as soon as they arrive.

Doctors said to that end their partnership with Dane County EMS is critical.

“We really heavily rely on both their rapid identification of these candidate patients but also their phenomenal conventional cpr while they transport the patient to our emergency department,” said Glazer.

EMS providers will need to consider a number of conditions when determining if a patient is eligible for ECMO.

Principal among those considerations is whether or not the cardiac event was witnessed or if the patient has a continuous pulse.

The reason being, EMS provides must be able to recognize when that cardiac event occurred to determine if the ECMO circuit can be connected in that sixty minute window needed to make the technology successful.

“This is a big mind changer for us because previously it was twenty minutes and I’m done, that’s you know you’re not going to live,” said Anderson. 

“Now we have to completely change our mind where it’s fifteen minutes, is this patient a candidate for ECMO? And if so now I gotta start to move,” he added.

According to Glazer out-of-hospital cardiac arrests affect over 350 thousand Americans each year and currently have a survival rate of less than ten percent.