To Mend a Broken Heart: Sutter Health Starts eCPR Protocol in San Mateo County
BURLINGAME, Calif. — If you’ve ever watched a televised medical drama, you’ve probably seen a doctor yell “clear” before delivering a jolt of electricity to re-start a patient’s heart. Unfortunately the shows make it seem like the defibrillator works every time. In reality, it doesn’t. Sometimes a faulty heart rhythm won’t return to normal even after multiple shocks, and if the problem is a blocked artery, no amount of shocks will help. In these cases, a patient’s only hope is to receive CPR while they are rushed to a hospital, and once there, receive advanced life support until doctors can repair their heart.
These two life-saving steps form the basis for a new emergency response protocol, called eCPR, which has the potential to decrease deaths from sudden cardiac arrest by 30 percent. Sutter Health affiliated Mills-Peninsula Medical Center is the first hospital in Northern California to adopt this new protocol, which was proven effective in a 2016 study by Minneapolis-St. Paul area hospitals.
‘Hands Free’ Device Performs CPR During Transport
Until recently, it’s been next to impossible to perform effective CPR while in transit. “Our protocol has been to perform CPR at the scene and start transport only if we can stabilize the patient,” said John Kammeyer, Fire Chief, San Mateo Central Fire. Unfortunately many patients never stabilize – and 95 percent of sudden cardiac arrest victims die before they even reach a hospital.
The widespread use of a mechanical CPR device is set to change that. The device, known as LUCAS (Lund University Cardiac Arrest System), continuously delivers the same 2-inch chest compressions that a human hand would during traditional CPR, but the machine makes the process “hands free.” This means that emergency medical technicians (EMTs) can start their drive to the hospital sooner. A LUCAS device is carried on every San Mateo Fire rig that serves the county and two of the LUCAS devices now in the field were donated by Mills-Peninsula Medical Center community benefit.
ECMO Buys Time for Treatment
Once a patient arrives at Mills-Peninsula Medical Center the second life-saving step – advanced life support – comes in. A special machine called ECMO or extracorporeal membrane oxygenation, pumps oxygenated blood through the patient’s body, allowing the heart and lungs to rest while an emergency cardiac procedure is performed.
ECMO can support patients for days to weeks while doctors treat their underlying heart condition and give the heart time to heal. “Historically ECMO has only been used in support of a planned cardiac procedure,” said Joe Walsh, M.D., an interventional cardiologist with Palo Alto Medical Foundation. “Under this new protocol we’re using ECMO on an emergency basis, but time is still of the essence.” This expanded use of ECMO can only be accomplished if the hospital has trained supportive personnel at the ready – which Mills-Peninsula Medical Center does.
Mills-Peninsula Medical Center launched its ECMO program in 2017 and has treated approximately 25 adults per year with the technology. Dr. Walsh is director of the ECMO Program and has seen first-hand that gallant CPR efforts and rapid use of ECMO can save lives.