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North Carolina's Atrium Health Wake Forest Baptist and Forsyth County EMS Launch Innovative Program to Improve Cardiac Arrest Outcomes
WINSTON-SALEM, N.C. – Atrium Health Wake Forest Baptist and Forsyth County EMS have launched a program, believed to be the first in North Carolina, designed to improve outcomes for patients suffering from cardiac arrest.
The innovative program, called eCPR, is designed specifically for patients in Forsyth County who experience sudden cardiac arrest caused by a life-threatening irregular heart rhythm, and who show signs that the damage can be reversed. The “e” in eCPR stands for ECMO (Extracorporeal Membrane Oxygenation) which is a heart and lung bypass machine.
Forsyth County EMS paramedics have received special training to identify patients who would be most likely to benefit from eCPR. In addition to the traditional CPR and defibrillation that patients receive on scene and in an ambulance, those who are candidates for eCPR will be placed on an ECMO machine once they arrive at Atrium Health Wake Forest Baptist Medical Center.
“In the U.S., the vast majority of patients do not survive cardiac arrest, but research has shown that survival rates can increase considerably by using ECMO,” said Dr. Stephen Powell, an emergency medicine physician at Atrium Health Wake Forest Baptist, an assistant professor of emergency medicine at Wake Forest University School of Medicine and the medical director for Forsyth County EMS.
“As the region’s only academic learning health system, we have unique capabilities and expertise that, when combined with the knowledge and skill of community partners such as Forsyth County EMS, can provide clear benefits to those we serve and ultimately save more lives.”
A 2020 study by the National Heart, Lung, and Blood Institute, part of the National Institutes of Health, showed that six of 14 patients (43%) who received ECMO treatment after a cardiac arrest survived to be discharged from the hospital, compared to just one of 15 (7%) who received only the standard treatment.
The University of Minnesota has demonstrated that a community-wide eCPR program can be successful, with their publication showing that 25 of 58 (43%) cardiac arrest patients, treated by ECMO, were discharged from the hospital and alive after three months, with normal function or only moderate disability.
“Our county wide patient care goal is to improve cardiac arrest survival,” said Forsyth County Emergency Services Director Chief Joey Hundley. “Not only that, we want to focus on patient-centered outcomes where the person not only survives, but they are the same person they were before their cardiac arrest.”
Dr. John Gaillard, associate professor of anesthesiology at Wake Forest University School of Medicine and attending physician in Atrium Health Wake Forest Baptist Medical Center’s cardiovascular intensive care unit, has used his knowledge and expertise to help develop the eCPR steering committee, which includes leaders from the emergency department, interventional cardiology, ICU and cardiothoracic surgery, to integrate their ECMO team to help more patients. This program requires enormous resources and Powell credits the experts in these areas for making this program possible.
Atrium Health Wake Forest Baptist will track the progress of the Forsyth County eCPR program to determine the feasibility of expanding the program in the future.
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