Emergency department initiation of cardiopulmonary bypass: a case report and review of the literature.

BACKGROUND: Out-of-hospital cardiac arrest carries a dismal prognosis. Percutaneous extracorporeal membrane oxygenation (ECMO) has been used with success for in-hospital arrests, and some literature suggests improvement in long-term survival for out-of-hospital arrests as well.

OBJECTIVES: This case highlights the use of ECMO in the emergency department.

CASE REPORT: We report a case in which emergency physician-initiated ECMO was used as a bridge to definitive care in an out-of- hospital cardiac arrest in the United States.

CONCLUSIONS: ECMO is a novel adjunct for patients in cardiac arrest in whom the usual advanced life support techniques have failed.