Episode 61 — ECPR With Scott Weingart
Highlights
- The Benefits of Immediate CPR for Patients with Short Arrest Times
Key takeaways:
- There is a gray zone when it comes to when CPR should be started, and it depends on the situation.
- If a patient is witnessed and is reasonably stable, CPR should be started immediately.
- If CPR is started later, it is more likely to be unsuccessful.
Transcript:
Speaker 1
They need a no flow time, meaning time without CPR to be very brief. Some programs would say up to five minutes, but I really like to see the witnessed with CPR being done right away or you heard your dad fall in the other room, went over, he's on response to immediately start CPR. That's a good no flow time. Going beyond about five minutes, it's going to be a real tough shot. Now, the interesting one is the duration of the arrest itself, prior to ECMO implantation. And that number keeps getting longer and longer. In fact, the Annapolis study, which had into the 40% neurologically intact survival rate, that was the, I don't remember if it was median or mean, but either way, it was 65 minutes, meaning a bunch of patients were way longer than an hour in order to get that time. So that, I have a very gray zone. I think if you get me a reasonable patient in any amount of field time, it's probably worth putting them on pump.
Speaker 2
So if it was witnessed or a very short time without any resuscitation and it's a reasonable patient, you might have a pretty long period of compressions and still have a good outcome. If it was, I suppose, hopefully well done compressions and so on.
Speaker 1
Yeah, absolutely can. (Time 0:06:11)