This push by @nytimes for widespread use of ECPR is a bad idea. -There's no strong data supporting its use and should be viewed as largely experimental -We still don't know who to sink this *very expensive* resource into and who not to -Invariably, as public demand goes up, indication creep will occur and we'll start cannulating more non-survivable patients -Most EDs will never see sufficient volume to justify trying to support a robust program nytimes.com/2024/03/27/mag… #emergency #emergencymedicine #foam #foamed #foamcc #army #armymedicine #armyemdoc #meded #icu #criticalcare #airway #research #science #data #heart #cpr #health
@armyemdoc @nytimes @American_Heart @ACCinTouch @ACEPNow ECMO?! Jeez I thought they were talking about a LUCAS device. @Dygear 💀
@armyemdoc @nytimes @American_Heart @ACCinTouch @ACEPNow Largely experimental? I mean, I’d suggest this is WILDLY experimental
@armyemdoc @nytimes @American_Heart @ACCinTouch @ACEPNow I worry we’ll get in an eCPR frenzy and transport some pts who could have been resuscitated on scene only to be rapidly transported for eCPR and an ED termination. “Who” and “when” is really the question for eCPR.
@armyemdoc @nytimes @American_Heart @ACCinTouch @ACEPNow Agree 100%. It's an attempt to replace workers and employees with something else that can be turned into a massive profit. These things are expensive, having adequate staffing instead of an expensive ECPR machine is foolish. Hell, I'd rather 2 med studs than one of these.
@armyemdoc @nytimes @American_Heart @ACCinTouch @ACEPNow when i saw the headline asking why we’re still relying on CPR versus eCPR, my first thought was: because you can perform quality CPR with no specialized equipment and a well-behaved chimpanzee
@armyemdoc @nytimes @American_Heart @ACCinTouch @ACEPNow seems reasonable for someone with expertise to try to write a rebuttal…
@armyemdoc @nytimes @American_Heart @ACCinTouch @ACEPNow Fully agree. The evidence to date does not support the use of ECPR, let alone it will create yet another tier of access in healthcare. I work in a rural/regional environment and we will probable never have access to this technology - until the robots take over….
@armyemdoc @BrooksWalsh @nytimes @American_Heart @ACCinTouch @ACEPNow high performing areas achieve an almost 5x improvement in survival rates thru a combination of education and community buy-in for bystander CPR, ubiquitous deployment of AEDs & high performance teams. Let’s start there rather than technically /financially challenging solutions.
@armyemdoc @nytimes @American_Heart @ACCinTouch @ACEPNow I completely agree. I work somewhere with a robust ECMO program, and I’ve selectively used ECPR very successfully for some very specifically likely to succeed cases. I still think we don’t have the kind of data needed to successfully implement and scale this nationally