When it comes to transporting critically-ill patients, the details matter.
Emory Healthcare’s ECMO program is the first in Georgia to put a new specialized ambulance on the road to transport critically ill adult patients who require extracorporeal membrane oxygenation, or ECMO.
ECMO is a highly advanced form of life support that provides cardiopulmonary support to persons whose heart and/or lungs are unable to function appropriately to keep them alive.
“ECMO works by replacing the heart and lungs, pumping blood in-and-out of the body, while removing the carbon dioxide and oxygenating blood,” says James M. Blum, MD, chief of critical care for the Emory Department of Anesthesiology and director of the Emory ECMO Center. “It allows life saving time essential for the treatment and recovery of the lungs and heart.”
Emory’s new critical care vehicle, created in partnership with MetroAtlanta Ambulance Service, was customized to the most minute detail with an interior that includes special equipment and expanded seating to accommodate the team needed to care for ECMO patients.
Proper transportation of ECMO patients requires a larger care team of at least four people, each with specialized knowledge and skills, versus two care team members in a regular ambulance, so additional seating was necessary for the unit. It also contains dedicated equipment for monitoring and lifting the patient because of the complexity of their illness and weight of the equipment.
“With the addition of this customized vehicle, Emory University Hospital is the only adult ECMO center in Georgia and one of the few in the country offering specialized transportation services from a referring hospital to an ECMO Center,” says Gartland.
During a transport mission, members of the Emory ECMO Center have the ability to stabilize patients by remotely initiating ECMO before the trip begins and subsequently transferring the patient to Emory University Hospital. Transporting extremely compromised patients without initiating ECMO has a very high mortality rate.
“For patients with severe cardiac or pulmonary failure who require transport to a specialized hospital like ours for advanced medical therapy, transportation can be a difficult and dangerous problem,” says Bryce Gartland, MD, chief executive officer, Emory University Hospital.
According to Blum, the specialized ambulance will allow patients within about a 70-mile range of the hospital to be transported in approximately four hours from the initial transfer request. The Emory ECMO Center also has established the ability to transport patients globally via air, having completed its first airborne transport in 2014.
The Emory ECMO Center is one of a few centers in the Southeast specializing in the management of adult patients. It provides a comprehensive team of clinicians, advanced technology, and protocols to support programs in respiratory failure, cardiac failure and bridges to transplantation.
“In the past, ECMO has mostly been used on children but the technology is being used more frequently in adults with cardiac and respiratory failure,” explains Blum, who has treated hundreds of ECMO patients and is recognized as a national leader in critical care.
The Emory ECMO Center is a leader in adult extracorporeal life support providing excellent clinical services in addition to a robust research base. It is the premier ECMO center in the Southeastern United States and uses a collaborative, multidisciplinary, team-based approach for the management of ECMO patients. In this model, Emory University Hospital intensivists direct a team of advanced practitioners, nurses, perfusionists, and respiratory therapists in the management of patients who have profoundly complex critical illness. For more information, please visit: http://ecmo.emory.edu/