Protocol report outlines a prehospital extracorporeal resuscitation framework for refractory cardiac arrest, indicating structured criteria can streamline emergency cannulation.
Key Points
To establish a standardized operational protocol for delivering prehospital extracorporeal cardiopulmonary resuscitation to eligible patients with refractory out-of-hospital cardiac arrest.
Designed a standardized pathway utilizing a dedicated two-person team (physician and paramedic) equipped with point-of-care ultrasound, a mobile oxygenator, and a pre-primed venoarterial extracorporeal membrane oxygenation circuit.
Established strict inclusion criteria (witnessed arrest, age <50 years, refractory arrest ≥15 minutes, ECMO flow feasible within 60 minutes) alongside ultrasound STOP criteria to rule out contraindications prior to femoro-femoral cannulation.
The operational workflow mandates a target interval of ≤15 minutes from the initiation of procedural steps to active extracorporeal blood flow.
Standardized checkpoints integrate real-time ultrasound guidance, failed-access algorithms, air-free circuit connections, post-flow stabilization, and expedited transport to a specialized cardiovascular center.
No patient-level outcome metrics are reported, with clinical feasibility, safety, survival rates, and neurological outcomes designated for prospective evaluation after launch.