Simulation training enables emergency medicine providers to rapidly and safely initiate extracorporeal cardiopulmonary resuscitation (ECPR) in a simulated cardiac arrest scenario

Whitmore, Sage P.; Gunnerson, Kyle J.; Haft, Jonathan W.; Lynch, William R.; VanDyck, Tyler; Hébert, Caroline; Waldvogel, John; Havey, Renee; Weinberg, Allison; Cranford, James A.; Rooney, Deborah M.; Neumar, Robert W.

doi:10.1016/j.resuscitation.2019.03.002

Cited by 42 publications

(26 citation statements)

References 21 publications

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“…High-volume ECMO centers have reported a wide range of times from cardiac arrest to establishment arrival time of < 30 min and an ED arrival to ECPR initiation time of < 30 min, did not achieve its primary endpoint of 80% success rate for each time target-with actual rates of 42% and 60%, respectively-further highlighting the challenges in limiting low-flow times even under tightly controlled trial conditions [33]. Among other considerations, simulation training may help ensure more rapid cannulation [64].…”

Section: Timing Of Initiationmentioning

confidence: 99%

Extracorporeal cardiopulmonary resuscitation in adults: evidence and implications

et al. 2021

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Rates of survival with functional recovery for both in-hospital and out-of-hospital cardiac arrest are notably low. Extracorporeal cardiopulmonary resuscitation (ECPR) is emerging as a modality to improve prognosis by augmenting perfusion to vital end-organs by utilizing extracorporeal membrane oxygenation (ECMO) during conventional CPR and stabilizing the patient for interventions aimed at reversing the aetiology of the arrest. Implementing this emergent procedure requires a substantial investment in resources, and even the most successful ECPR programs may nonetheless burden healthcare systems, clinicians, patients, and their families with unsalvageable patients supported by extracorporeal devices. Non-randomized and observational studies have repeatedly shown an association between ECPR and improved survival, versus conventional CPR, for in-hospital cardiac arrest in select patient populations. Recently, randomized controlled trials suggest benefit for ECPR over standard resuscitation, as well as the feasibility of performing such trials, in out-of-hospital cardiac arrest within highly coordinated healthcare delivery systems. Application of these data to clinical practice should be done cautiously, with outcomes likely to vary by the setting and system within which ECPR is initiated. ECPR introduces important ethical challenges, including whether it should be considered an extension of CPR, at what point it becomes sustained organ replacement therapy, and how to approach patients unable to recover or be bridged to heart replacement therapy. The economic impact of ECPR varies by health system, and has the potential to outstrip resources if used indiscriminately. Ideally, studies should include economic evaluations to inform health care systems about the cost-benefits of this therapy.

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Section: Timing Of Initiationmentioning

confidence: 99%

Extracorporeal cardiopulmonary resuscitation in adults: evidence and implications

et al. 2021

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“…All the simulations were prepared using the principle of the suspension of disbelief to help the attendees learn using scenarios similar to their clinical practice but in a controlled environment without any consequences for the patients. 7,[9][10][11] At the end of each session, a debriefing was performed with the attendees to fix any concerns and improve both their technical and behavioural skills. Participant examination was not performed due to the lack of time.…”

Section: Methodsmentioning

confidence: 99%

ECLS Training and Simulation - Evaluation of the 8th Educational Corner of the EuroELSO Congress 2019 Held in Barcelona

et al. 2020

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Introduction: Simulation-based learning and hands-on learning are popular in medicine, particularly in areas where life-saving manoeuvres and team skills are required. Simulations can be provided in different environments: directly in hospitals (in situ), in dedicated facilities (simulation rooms) or, on occasion, at scientific meetings, thus taking advantage of the delegates’ motivation. Simulation-based learning in extracorporeal life support is also increasingly relevant due to the inherent features of the often difficult and emergent decision-making, approaches and management involved, as well as to the challenging multidisciplinary teamwork. Aim: Based on these premises and on the constant rise in interest in starting new extracorporeal life support programmes, the EuroELSO organization has, since the beginning of its scientific activities, established an ‘ad hoc’ space (Educational Corner) for training and hands-on sessions with a limited number of attendees per session during its annual congress. Methods: Experienced trainers deliver repeated dedicated sessions on fundamental aspects of extracorporeal life support management. After several years of sessions, a questionnaire was prepared and delivered to the attendees at the 8th annual congress in Barcelona. Results: More than 90% of the responders indicated that they would recommend the workshop to their colleagues and that they received useful information during the workshops. Over 85% of the responders (85-97%) indicated that the workshops met the set educational goals and objectives and indicated that the simulation sessions would have a positive impact on their daily practice. Conclusion: The Educational Corner during the EuroELSO Congress has achieved great popularity, as shown by the number of attendees participating each year, and presumably improves many technical and behavioural skills among the attendees.

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“… 7 A small before-after study in the paediatric population reported a significantly reduced ECMO deployment time after the implementation of a high-fidelity simulation program 8 and, in adults, a prospective cohort study examining the utility of high-fidelity simulation training in ECPR delivery in the emergency department (ED) reported sustained improvements in time to ECMO support in a simulation setting following completion of a three-day program. 9 Taken in summation, this presents a unique opportunity to explore the effect of targeted ECPR simulation training on time to ECMO flow and favourable neurological outcome in ECPR patients. To our knowledge, no study has examined the real-world effect of such a program on ECPR utilisation and outcomes in adults.…”

Section: Introductionmentioning

confidence: 99%

The effect of a structured ECPR protocol aided by specific simulation training in a quaternary ECMO centre: A retrospective pre-post study

et al. 2022

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Simulation training enables emergency medicine providers to rapidly and safely initiate extracorporeal cardiopulmonary resuscitation (ECPR) in a simulated cardiac arrest scenario

Cited by 42 publications

References 21 publications

Extracorporeal cardiopulmonary resuscitation in adults: evidence and implications

Extracorporeal cardiopulmonary resuscitation in adults: evidence and implications

ECLS Training and Simulation - Evaluation of the 8th Educational Corner of the EuroELSO Congress 2019 Held in Barcelona

The effect of a structured ECPR protocol aided by specific simulation training in a quaternary ECMO centre: A retrospective pre-post study

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