Year-in-Review-2021-22 - Flipbook - Page 145
District joins world-leading cardiac
arrest treatment trial
More than 20,000 Australians suffer a cardiac
arrest outside of hospital every year – but only one
in 10 survive.
Now, RPA and Concord hospitals are part of a
world-leading randomised control trial with NSW
Ambulance to find the very best way to treat
cardiac arrest patients and ensure their survival.
The EVIDENCE trial, which started in July and
continues for two years, involves more than 1300
paramedics and 15 hospitals across Sydney and
Wollongong.
It tests various methods of mechanical CPR such
as the Lucas device which automatically delivers
chest compressions and ECMO (extracorporeal
membrane oxygenation), a heart/lung bypass
machine which gives the patient’s heart a chance
to rest while clinicians diagnose and treat the
cardiac arrest.
About 400 Lucas devices are currently in
ambulances across the state.
“The trial is currently the largest of its kind in the
world being undertaken in terms of geography,
paramedics and hospital numbers involved,” Dr
Mark Dennis, an RPA cardiologist and chief trial
investigator, said.
Year in Review 2021–22
“Early recognition of cardiac arrests, effective
bystander CPR which ensures good blood flow
to the brain and heart, defibrillation and more
advanced medical interventions are critical in
improving survival rates.
“Recent overseas studies, in smaller cities and
involving only one hospital, have shown that
bundles of out-of-hospital cardiac arrest care,
including early recognition, early transfer,
mechanical CPR during extrication and transport
and coronary angiography and ECMO are
beneficial in selected patients,” Dr Dennis said.
RPA is a leading site in NSW for ECMO, sharing
statewide ECMO retrieval team duties with St
Vincent’s Hospital.
This week, RPA and NSW Ambulance clinicians
ran a simulation exercise in Camperdown where
a “patient” (a mannequin) suffering a cardiac
arrest was placed on a Lucas device on scene
by intensive care paramedics and taken to RPA’s
Emergency Department where ICU and ED staff
put them on ECMO, within minutes of arrival.
“Time is a critical aspect of cardiac arrest
management. Carefully selected patients must
be placed on ECMO in under 60 minutes from
the time of the arrest for a meaningful outcome,”
Dr Dennis said.
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