INTRODUCTION:Extracorporeal cardiopulmonary resuscitation (ECPR) holds promise to improve outcomes for out-of-hospital cardiac arrest but requires careful patient selection, timely application, and rigorous quality assurance (QA) to be effective. The initial ECPR process is critical for the individual patient; that is, neuro-intact survival is highly dependent on minimizing low-flow time. It is equally important for the longevity of the ECPR program itself, as preventable false activations erode both necessary multi-disciplinary stakeholder commitment and response time. Here-in we describe a novel tool developed to: 1) provide a maximallyrapid and sensitive ECPR consultation followed by a specific, robust, and expeditious ECPR activation; 2) generate an automated and accurate database of all ECPR consults and activations for QA purposes.

The rates of survival with functional recovery for out of hospital cardiac arrest remain unacceptably low. Extracorporeal cardiopulmonary resuscitation (ECPR) quickly resolves the low-flow state of conventional cardiopulmonary resuscitation (CCPR) providing valuable perfusion to end organs. Observational studies have shown an association with the use of ECPR and improved survivability. Two recent randomized controlled studies have demonstrated improved survival with functional neurologic recovery when compared to CCPR. Substantial resources and coordination amongst different specialties and departments are crucial for the successful implementation of ECPR. Standardized protocols, simulation based training, and constant communication are invaluable to the sustainability of a program. Currently there is no standardized protocol for the post-cannulation management of these ECPR patients and, ideally, upcoming studies should aim to evaluate these protocols.

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