Street ECMO in Paris

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TrailRun

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Does anywhere in the US do this? Feels like we're a bit behind the ball, with subway ECMO in Paris, HEMS doing roadside thoracotomies in London, etc.

http://www.jems.com/articles/print/...prehospital-ecmo-on-the-streets-of-paris.html

The outcomes seem improved compared to what we do, but I know from a financial standpoint the hospital can make more money having a physician see x pts in the time it would have taken for them to go out on one community call.

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France's trauma system used to be terrible. They have really upped their game. Yes, we are behind, but we don't pay for physicians on ambulances. It's a huge problem. Guess the EMS unions are mightier than MDs.
 
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Where is the research supporting pre-hospital ECMO? It seems most research supports basic level care with rapid transport. The Canadians have studied this pretty well.

As I've mentioned in a previous post, do I need to remind anyone that the stay-and-play approach by SAMU is what cost Princess Diana her life?
 
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Scoop and poop is the way to go.
 
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There's some evidence for nontraumatic cardiac arrest. Trauma is a different issue, of course.

Aggressive ECMO increases survival in refractory cardiac arrest
Sort of like how tPA increases survival in stroke. Except the data isn't very clean, and it cost an absolutely absurd amount.
I mean, they did ECMO in the Louvre for God's sake. You want to talk about thoracotomies, or REBOA, then we can chat. Those don't require the fancy machines and correct the problem right then while waiting for definitive cure.
 
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