EDECMO Podcast - Zack Shinar, MD

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https://www.resuscitationjournal.com/article/S0300-9572
5 partages
https://edecmo.org/edecmo-episode-14-ecpr-stephen-bernard/
5 partages
https://edecmo.org/wp-content/uploads/2014/08/SAVE-J.pdf
4 partages

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3492121/
1 partage
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010695/
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6688510/
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https://twitter.com/edecmo
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96: ECPR in India and China

mardi 29 avril 2025 • Durée 27:14

Zack Shinar interviews Pranay Oza, an intensivist from Mumbai, and Simon Sin, an intensivist from Hong Kong, about the insights, necessities, and opportunities for ECPR in India and China. Both of these physicians are leading the charge in places where ECPR is exploding. Listen to this podcast to learn how they optimize their skills and resources to utilize this powerful tool.

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95: ECPR Organ Procurement with Stephen Wall

jeudi 27 mars 2025 • Durée 46:48

Jon interviews Dr. Stephen Wall from NYU on the podcast where they discuss the need for organs and how ECPR inclusion criteria can significantly impact the problem.

Stephen P. Wall, MD MSHS MAEd, is Tenured Associate Professor in the Departments of
Emergency Medicine and Population Health, NYU Grossman School of Medicine. Dr Wall was
project manager and lead methodologist for the NYC uncontrolled donation after circulatory death
(uDCD) program that attempted to increase kidney donation opportunities by considering those who
die unexpectedly outside hospitals. Results showed the public was supportive of uDCD, so long as
permission is obtained prior to any invasive procedures being performed on the deceased. Lessons
learned from the Kidney uDCD program provided justification to attempt in-hospital Lung uDCD in
NYC, a project funded by NHLBI (R61/R33HL156890 – PIs Wall and Robert Montgomery, MD PhD).
These projects involve cross-disciplinary collaborations with bioethicists, clinical experts from
medicine, surgery, emergency medicine, and transplantation, both within and external to hospitals
and academic medical centers. Dr. Wall’s research was covered in news media including NPR,
NBC, and the Atlantic.

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86: UCLA ECPR with Vadim Gudzenko

mercredi 6 septembre 2023 • Durée 37:36

This episode is a follow up to last month’s episode with Nichole Bosson. Zack interviews Vadim Gudzenko about the in-patient aspects and critical care doctor perspective on the Los Angeles OHCA ECPR program. A few take homes are that EMS is critical to any OHCA ECPR program. Nurses need support for these intense patients with high mortality. And emergency physicians need to buy in to the idea of ECMO for cardiac arrest to make a successful program.

Upcoming Events

Sept – ELSO – Summary – 34th Annual ELSO Conference (cvent.com)

Oct – Prague ECPR School – https://www.ecprprague.com/

Nov – Reanimate Reanimateconference.com

Zack and Jon’s Editorial about Sakuraya PE trial

https://authors.elsevier.com/a/1hlr514RWGNg8s

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Episode 5 – Cognitive Task Analysis of Stages I and II of Extracorporeal CPR

jeudi 13 mars 2014 • Durée 31:16

Joe and I discuss ECPR cannulae placement from a cognitive task analysis (sort of) perspective. Beware: agonizing detail follows.

I believe this episode may help you even if you never do ECMO, as it is directly applicable to large central line placement as well.

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Steven Bernard on the CHEER Trial from Intensive Care Network

mardi 11 mars 2014 • Durée 23:38

The amazing blog and podcast: Intensive Care Network run by Oli Flower and Matt Mac Partlin recorded this lecture by Steven Bernard talking about the CHEER Trial of ECPR.

Dr. Bernard’s Slides Now on to the Lecture…

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Episode 4 – The Tactical Approach to the Cardiac Arrest

samedi 1 mars 2014 • Durée 18:49

In this episode we talk about how we prepare for, and run, our codes. When we began incorporating ECPR into our resuscitation strategy we found ourselves saving patients who would have otherwise died. The traditional nihilistic approach to the arresting patient was overturned with ECPR by providing hope that wasn’t previously there. Naturally, we took a closer look at each element of the code, from the time the patient hit the door to the time we started the pump. And we realized we were doing a lot of stuff wrong. Here is how I do it:

1. Medic gurney entry: If you’re doing ECPR, then vascular access of the femoral vessels is a top priority. Most of us are right handed and prefer to access the femoral vasculature on the patient’s right. But that’s EXACTLY where the medic gurney offloads the patient- big mistake. Time is wasted waiting for the medics to move the patient to your hospital gurney, remove monitor leads, pack up the monitor, avoid pulling out IV’s and then leave the room. Only then could the “line doctor” push the ultrasound machine into the room, disrobe the patient, gown up, place a sterile US probe cover, prep the field and get to work. That’s precious minutes wasted. Stop doing that! Bring the medic gurney in on the other side! Your “line doctor” is already completely ready to go.

2. Protocolize EVERYTHING: ACLS provides a protocolized framework for running a code. But what about all that stuff that happens from the ambulance bay until care is transferred to you? And can we improve on the current ACLS algorithm? Most of us appreciate that protocoling doesn’t restrict us; in fact, quite the opposite. A protocol allows cognitive offloading of important, yet routine, steps in a process which frees us to focus on tasks specific to that patient.

If you are considering establishing an ED ECMO or ECPR program at your facility, I highly recommend that you take a close look at everything that is done from the time the patient hits your door to the time the ECLS pump is started. We aren’t saying this is the only way to do it, but this is how we do it:

Anticipating the Arrival of an Arresting Patient:

Staging the room: not unlike a theatrical play, each person and each piece of equipment has a specific role and a specific position in resuscitation suite. Do it the same way every single time.

Accepting the CPR patient on the “RIGHT Side!” Patient Arrival:

Resuscitative ECMO Interview from EMCrit.org

vendredi 14 février 2014 • Durée 28:03

This is the interview that started all of the trouble. Scott got to interview Joe on the amazing resuscitative ECMO program at Sharp Memorial in San Diego on an episode of the EMCrit podcast.

Episode 3 – Who the HELL do we put on ECMO during Arrest?

mercredi 12 février 2014 • Durée 15:46

Who Gets ECPR and Who Doesn’t?

Great question! This may be the hardest question we deal with when a patient arrives and ECPR is a consideration.

This episode is broken down into three parts:

Who exactly do we consider an appropriate candidate for ECPR?
TOR = Termination of Resuscitation in the pre-hospital arena and why we HATE it!
Pre-hospital ECPR – REALLY?

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Episode 2 – The Three Stages of ECPR

vendredi 7 février 2014 • Durée 17:33

In this episode, Joe and Zack discuss the three stages of ECPR initiation.

For greater detail, videos, and simulations come to the ECPR Page in the tutorial section.

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Episode 1 – An Introduction to ECMO Terminology

dimanche 2 février 2014 • Durée 07:07

In this episode, Joe and Zack discuss some of the terminology and basics of ECMO and ECLS.

Terminology: (Synonyms)

ECMO = Extracorporeal Membrane Oxygenation
ECLS = Extracorporeal Life Support
CPS = Cardiopulmonary Support
ECPR (extracorporeal cardiopulmonary resuscitation)=ECLS initiation in the arresting patient

ECPR candidates:

STEMI with refractory VFIB
PE with shock or dysrythmia
Aortic Dissection
Massive OD
Pregnant with Amniotic fluid embolus
Hypothermia with temperature-dependent dysrythmia
Trauma

Future podcast episodes will drill down into the details of ECMO initiation, but in this episode Zack and Joe discuss Zack’s recent case where Zack did it all: managed the code…placed the cannulas…and initiated bypass, right there in the Emergency Department.

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