Emergency care strengthens locally with launch of new eCPR program
After years of rigorous testing and planning, University of Iowa Hospitals & Clinics is launching an extracorporeal cardiopulmonary resuscitation (eCPR) program for patients experiencing sudden cardiac arrest.
“We are uniquely equipped to be the first to launch this program in Iowa,” says Pete Georgakakos, DO, emergency medicine physician. “To launch a successful program like this, you need manpower, logistic support, and incredible expertise. We’ve spent the last few years getting it right.”
Georgakakos says the team collaborated with various stakeholders—including the ECMO team, Cardiovascular Intensive Care Unit (CVICU), the emergency department, cath lab team, Johnson County Ambulance Services, and more—to work through numerous simulations to prepare UI Health Care faculty and staff to successfully launch an eCPR program.
This program will launch Wednesday, Nov. 1.
What is eCPR?
eCPR is a process where extracorporeal membrane oxygenation (ECMO) is initiated emergently on patients who have had cardiac arrest and for whom conventional cardiopulmonary resuscitation (CPR) or an automatic external defibrillator (AED) has failed.
ECMO allows a patient’s lungs and heart to rest and heal by recirculating blood from the body through an artificial lung, or oxygenator. While ECMO can be done in various clinical areas, eCPR relies on the use of advanced technology and expertise of a cardiac catheterization (cath) lab like those in the hospital’s recently renovated Cardiovascular Invasive Procedure Unit.
Traditional resuscitation efforts—such as CPR or use of an AED—remain a necessary step when treating a person experiencing cardiac arrest.
But during such events, minutes matter. Successful resuscitation depends on treatment with CPR and an AED within two to three minutes of the person’s collapse. For eCPR to be a viable option, a patient must be on ECMO within an hour after the event begins. Due to these time constraints, the program is only offered to patients who experience cardiac arrest in Johnson County.
“This won’t be a viable option for every patient,” Jason Allen, MD, cardiologist, says. “But for those patients first responders can get to our main campus within 30 minutes, this is another option that has shown great success in improving survival rates after cardiac arrest.”
Know the signs
Sudden cardiac arrest (SCA) happens when a child or adult collapses because of an abnormal heart rhythm known as ventricular fibrillation. This disorganized heart rhythm causes the heart to suddenly stop beating normally, and blood does not pump through the body. Because blood isn’t reaching the lungs or brain, the person suddenly passes out and becomes unresponsive with no pulse and abnormal or no breathing.
Experts advise it’s important to understand the signs and risks of sudden cardiac arrest.
Warning signs of possible SCA risk:
Discomfort, pain, or pressure in the chest during or after exercise
Fainting, nearly fainting, or seizure-like activity during or after exercise, emotion, or surprise
Excessive, unexpected, and unexplained fatigue or shortness of breath with exercise
Skipping or racing heartbeats
Family history of sudden death before age 50 or heart abnormalities
SCA is typically treated with an AED, a life-saving device that looks for a shockable heart rhythm and delivers a shock only if needed. It is small, portable, automated, and easy to operate. Voice prompts give instructions, and AED will not shock someone unless it is needed.