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EDECMO.org is a non-commercial source to discover the life-saving potential of resuscitative extra-corporeal membrane oxygenation (ecmo) and extra-corporeal life support (ecls). We will teach you the skills and break down the logistics to allow resuscitationists to initiate ECMO in the ED or ICU.

EDECMO.org is a non-commercial source to discover the life-saving potential of resuscitative extra-corporeal membrane oxygenation (ecmo) and extra-corporeal life support (ecls). We will teach you the skills and break down the logistics to allow resuscitationists to initiate ECMO in the ED or ICU.
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United States

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EDECMO.org is a non-commercial source to discover the life-saving potential of resuscitative extra-corporeal membrane oxygenation (ecmo) and extra-corporeal life support (ecls). We will teach you the skills and break down the logistics to allow resuscitationists to initiate ECMO in the ED or ICU.

Language:

English


Episodes

56: Pressors, Fluid, or Flow – Optimizing ECMO Physiology

7/8/2019
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A post arrest patient just got initiated on ECMO. Do you give fluids, add pressors, or increase flow? Marc Dickstein, an anesthesiologist from Columbia University and an expert in the physiology of ECMO, talks with Zack about how to manage these patients, what diagnostics we need and how to optimize your use of the machine. This talk is a must for everyone starting ECPR in their departments. The post 56: Pressors, Fluid, or Flow – Optimizing ECMO Physiology appeared first on ED ECMO.

Duration:00:36:36

55 – Anticoagulation of the ECMO Patient with Troy Seelhammer

6/4/2019
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Do you give heparin to your ECMO patients? Well, let's rethink this. This episode is All Things Anticoagulation! Zack talks with Troy Seelhammer, an intensivist from Mayo Clinic Rochester. He manages ECMO patients in his daily practice there. He has become a master of the subject of anticoagulation. He will talk about heparin, bilvalirudin, or maybe no anticoagulation. He talks about the when to be aggressive and when to cut back. Below is a wonderful synopsis of Troy's thoughts on...

Duration:00:31:25

54: Confirmation of Wire Placement with Sacha Richardson

5/8/2019
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In this episode, Sacha Richardson talks with Zack about a problem common to all ECPR programs- how do we confirm the placement of the wires? During chest compressions and even in patients with a pulse, confirmation of which vessel you have cannulated can be difficult. Sacha shares some tricks and trips on how to get real time confirmation of the wires. Sacha also gives us a preview of some of the exciting endeavors that he has undertaken in Melbourne with pre-hospital ECMO. The post 54:...

Duration:00:23:28

53b: Resuscitationist Inserted Distal Perfusion Catheter with Chris Couch

4/4/2019
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In this episode, we again explore the world of the distal perfusion catheter. You heard from Joe Dubose the vascular surgeons point of view; now let's see how non-surgeon resuscitationists are dealing with this problem. You will hear from Chris Couch, a critical care trained emergency physician from Dallas Texas and his colleague Omar Hernandez who have some novel thoughts and experiences related to when and how we insert these catheters. You will hear about checking compartment pressures,...

Duration:00:29:41

53: Distal Perfusion Catheter with Joe Dubose

4/1/2019
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Episode 53 is all about the distal perfusion catheter12. We are inserting a 15-19 Fr catheter into the femoral artery. This limits the flow of blood to the affected extremity. Many institutions have gone to mandatory distal perfusion catheters. This episode is all about those catheters - when, how, which, and where. Joe Dubose, the world reknown vascular and trauma surgeon, joins us to discuss the details of this important piece of post pump initiation. The post 53: Distal Perfusion...

Duration:00:27:28

52: Brain Freeze- Selective Retrograde Cerebral Perfusion for Intra-Arrest Neuroprotection

3/5/2019
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We've all heard of therapeutic hypothermia. Some of us have heard of deep hypothermia for traumatic arrest. But what about deep regional hypothermia of brain for cardiac arrest! Zack interviewed Rob Schultz, a CT surgeon resident from Calgary who is doing research on deep hypothermia of the brain using some of the tactics that are utilized in operating room. His stuff is mind blowing! The post 52: Brain Freeze- Selective Retrograde Cerebral Perfusion for Intra-Arrest Neuroprotection...

Duration:00:23:11

51 – Proximal Balloon Occlusion for Cardiac Arrest

2/12/2019
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You've heard of ECMO for cardiac arrest- utilizing a mechanical pump to aid in perfusion of the coronaries. What if you can't do ECMO? What if your resources are such that simply can't lug a 10 kilogram machine out into the field? Well, Jostein Brede may have something for you to consider. He and several other places worldwide are on the forefront of using a REBOA catheter to occlude the proximal aorta during chest compressions in hopes that coronary perfusion pressure increases. This would...

Duration:00:27:28

50b Inter-Facility Transport of ECMO patients Part 2 of 2

12/5/2018
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This is part 2 of Transport of ECMO patients. Mikael Broman is one of the world's leaders on ECMO transport. He works at the Karolinska institute in Sweden and has and continues to publish in the arena of ECMO transport. As you will see, he offers a world of experience and certainly some critical information that we would all benefit from listening to. I'm a smarter ECMO-tologist as a result of Micke! The post 50b Inter-Facility Transport of ECMO patients Part 2 of 2 appeared first on ED...

Duration:00:48:51

50a Inter-facility Transport of ECMO patients Part 1 of 2

12/5/2018
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This month we are looking at how to transport patients from one facility to another on ECMO. This is difficult task full of potential catastrophes. Zack interviews Leon Eydelman, an ER/Critical Care physician from Chicago, and Michael Broman out of Karolinska in Sweden. Leon will be bringing us up to speed on what to do, potential fails, and how to start the process of setting up a transport process for ECMO patients. Dr. Eydelman will be teaching a new section at Reanimate this January...

Duration:00:23:18

49 – You Can’t Spell REBOA without the ER – Endovascular Resuscitation of the Trauma Patient – Zaf Qasim

10/12/2018
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n this episode, Zack Shinar interviews Zaf Qasim about the recent controversies with ACEP and ACS about who can do REBOA. Zaf is one of the world's experts on REBOA and he's an ER doc! Zaf works at the University of Pennsylvania, trained in London as well as Shock Trauma in Baltimore and teaches at Reanimate. When you come to the essence of this episode, the question is what is the emergency physician's role in the trauma resuscitation? Both Zaf and Zack agree; we need to be the...

Duration:00:37:14

EDECMO 48: When Should I Transport a Cardiac Arrest?

8/10/2018
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This part two of August 2018. We are now tackling the difficult question of when to transport cardiac arrests if I have ECMO available? Brian Grunau is an expert in this question. Brian has become a giant in the world of ECMO. His research, leadership and experience have pushed the Canadian ECPR contingency to the forefront. Brian gives us some insight on what factors I should consider and when should I transport. The post EDECMO 48: When Should I Transport a Cardiac Arrest? appeared first...

Duration:00:35:12

EDECMO 47: ECMO Donazione: Organ Transplantation with Velia Antonini

8/4/2018
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Over this last year we have had episodes on organ donation and decision to transport. This month we are revisiting two topics with two amazing people in two separate episodes. Here, I interviewed Velia Marta Antonini. Velia works in Italy where several of the great ECMO donation papers have originated. She explains why this research is coming from Italy, what the process looks like, and the implications of this for other countries. Check out her slides below. The post EDECMO 47: ECMO...

Duration:00:20:24

EDECMO 46: Wire Assistant

7/5/2018
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Well, it only took us seven years to figure this one out. The wire assistant has been the key advancement of 2018 for placement of ECMO cannulas. In this episode, Zack and Joe talk through this process after an interview with Alyssa Baldini. Alyssa was one of our first true wire assistants and has been instrumental in getting cannulas in faster and safer. We discuss how the wire assistant aids in sterility and getting the artery on the first stick. Bottom line - train someone at your shop to...

Duration:00:25:25

EDECMO 45: ECMO in Sepsis

5/10/2018
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In this episode, Zack talks with Heidi Dalton about ECMO use in Sepsis. This is another controversial area with pediatric literature showing strong results while the adult results have been less impressive. Heidi has been a key figure in both adult and pediatric ECMO. She is the former chair of the yearly ELSO conference. She is a professor at both George Washington University and Virginia Commonwealth University. Her background is in pediatric critical care. She currently works at INOVA in...

Duration:00:31:02

EDECMO Crash Episode – Demetris Yannopoulos on ECPR-the Minneapolis Way

4/8/2018
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Yanno on ECPR The post EDECMO Crash Episode – Demetris Yannopoulos on ECPR-the Minneapolis Way appeared first on ED ECMO.

Duration:01:18:47

EDECMO 44: Bob Bartlett: Peristaltic Pumps, Hollow Fibers, and the History of ECMO

3/21/2018
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In this episode, Zack interviews Bob Bartlett from the University of Michigan. He is truly the godfather of ECMO and has revolutionized the world with his leadership and innovation. They discuss the history of ECMO and roller pumps and bubble oxygenators were clearly inferior to their current counterparts - centrifugal pumps and hollow fiber oxygenators. They also discuss anticoagulation and how Bob feels direct thrombin inhibitors are superior. They also discuss the future of ECMO and how...

Duration:00:36:57

EDECMO 43: The Cutdown

2/20/2018
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In this episode, Alice Hutin of the Paris SAMU talks about the modified cutdown approach to cannula insertion. She is an emergency physician who is one of four physicians who take call on the pre-hospital ECMO ambulance. She describes the process of their modified cutdown. First, incision through the skin is made 2 cm below inguinal crease. Second, blunt dissection down through the soft tissue. This is best done with your fingers. Third, place a needle through the distal skin and visualize...

Duration:00:29:48

EDECMO 42: Organ Transplantation On ECMO

1/16/2018
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In this episode, we tackle the subject of organ transplantation on ECMO. 2017 featured several articles showing the efficacy of ECMO for organ transplantation. In Italy, 56% of total potential patients were successfully transplanted. The success of these transplants have been comparable to patients not on ECMO. Zack Shinar interviews Lionel Lamhaut, ECMO specialist from […] The post EDECMO 42: Organ Transplantation On ECMO appeared first on ED ECMO.

Duration:00:32:10

EDECMO 41 – The 3 Stages of ECPR – Diane’s Story

12/29/2017
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In this episode Zack and Joe discuss the 3-stages of Extracorporeal Membrane Oxygenation (ECMO) - or put another way, this is how to start Extracorporeal Cardiopulmonary Resuscitation (ECPR) in the Emergency Department (ED). It's been 4 years since we talked about these basic premises of ECPR. But this time, its highlighted in a very special story. The post EDECMO 41 – The 3 Stages of ECPR – Diane’s Story appeared first on ED ECMO.

Duration:00:30:32

EDECMO 40: EROCA – The trial that asks “Should ER Docs Initiate ECPR?”

11/2/2017
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EROCA – University of Michigan – Gunnerson/Shinar Should Emergency Physicians initiate ECMO on arresting patients? That is the question that Kyle Gunnerson from the University of Michigan (UMich) is asking with their new trial – EROCA. UMich has had a robust ECMO program for over 30 years and recently they have received a grant […] The post EDECMO 40: EROCA – The trial that asks “Should ER Docs Initiate ECPR?” appeared first on ED ECMO.

Duration:00:28:35