What to do if the heart stops beating suddenly? ECPR can save the patient in 20 minutes

Many people suddenly fall to the ground for unknown reasons, or lose their pulse and heartbeat in an instant. If such accidents happen, people are often caught off guard, but as long as the golden time is seized for treatment, there is still a chance to regain health. Especially now that the integration of medical resources continues to improve, doctors point out that if a patient is diagnosed with pre-hospital cardiopulmonary arrest (OHCA), at this time, emergency medical care will urgently perform repeated electric shocks on the patient. If it is still ineffective, the doctor will immediately start the ECPR (ECMO+CPR) process after evaluating the indications, that is, ECMO plus high-quality cardiopulmonary resuscitation, and the doctor will install ECMO to increase the first line of life for dying patients.

How to give first aid to OHCA patients?

In winter, the temperature difference between morning and evening is large. For every 1℃ drop in ambient temperature, the chance of sudden death increases by 5.4%. Among them, people with cardiovascular diseases are the majority, and those with a history of chronic three highs and smoking and drinking habits are also one of the risk groups.

The attending physician of the Department of Cardiovascular Surgery further explained that cold weather can cause vasoconstriction and increased blood pressure, which can increase the burden on the heart and may induce acute diseases such as myocardial infarction. The doctor emphasized that if people have respiratory failure when they arrive at the hospital, and the blood oxygen cannot be increased after emergency intubation, and they lose their pulse and their heart stops beating, the emergency room will immediately start the ECPR process (ECPR=ECMO+CPR, ECMO and high-quality cardiopulmonary resuscitation) to rescue the patient.

Is ECPR a lifeline for dying patients?

When traditional emergency treatment is ineffective, the hospital will start ECPR in time, which can temporarily replace the patient's cardiopulmonary function, support the patient through the critical course of the disease, and strive for time to diagnose the cause and conduct follow-up treatment.

In addition, according to a paper published in the internationally renowned medical journal LANCET, before ECPR was widely used, emergency treatment for OHCA patients was limited to CPR, advanced cardiac life-saving surgery, injection of cardiotonic drugs, etc., and the survival rate of patients who recovered and were discharged from the hospital was about 15%.
If ECPR is activated, high-quality CPR is continued and ECMO is placed, the survival rate can be increased to 30%, which not only significantly improves the survival rate, but also helps reduce brain damage and improve neurological prognosis, bringing a ray of hope to dying patients.

Who is suitable for ECPR?

Because ECPR requires a high level of human and material resources, and ECMO resources are limited, hospitals have standardized its applicable and exclusion conditions.

 Conditions for initiating ECPR:
 Bystander witnesses the patient fall to the ground and immediately performs CPR
 The initial heart rhythm is shockable
 No more than 60 minutes from the time 119 receives the notification to the arrival at the hospital
 Spontaneous circulation is restored after emergency treatment but still unstable
 Excludes conditions for initiating ECPR:
 Irreversible condition
 Serious comorbidity
 Inability to tolerate anticoagulant therapy
 Severe obesity (BMI>40)
 Cognitive impairment and brain damage
 Unable to take care of oneself
 Family members have expressed DNR (Do Not Resuscitate) intentions

Doctors emphasize that when receiving a notification, the ambulance personnel should usually be able to quickly review whether the case meets the conditions for acceptance, and notify in advance to shorten the preparation time of the ECPR team, eliminate all time obstacles as much as possible, thereby increasing the patient's survival rate and improving the prognosis.