title: The incidence of "load&go" out-of-hospital cardiac arrest candidates for emergency department utilization of emergency extracorporeal life support: A one-year review.
abstract: BACKGROUND
  The outcome of patients after out-of-hospital cardiac arrest (OHCA) is poor and gets worse after prolonged resuscitation. Recently introduced attempts like an early installed emergency extracorporeal life support (E-ECLS) in patients with persisting cardiac arrest at the emergency department (ED) are tried. The "Vienna Cardiac Arrest Registry" (VICAR) was introduced August 2013 to collect Utstein-style data. The aim of this observational study was to identify the incidence of patients which fulfil "load&go"-criteria for E-ECLS at the ED.
  
  
  METHODS
  VICAR was retrospectively analyzed for following criteria: age <75 years; witnessed OHCA; basic life support; ventricular fibrillation/ventricular tachycardia; no return-of-spontaneous-circulation (ROSC) within 15 min of advanced-life-support, which were supposed as potential optimal criteria for "load&go" plus successful E-ECLS treatment at the ED. The observation period was from August 1, 2013 to July 31, 2014.
  
  
  RESULTS
  Over 948 OHCA patients registered during the study period; data were exploitable for 864 patients. Of all patients, "load&go"-criteria were fulfilled by 55 (6%). However, 96 (11%) were transported with on-going CPR to the ED. Of these 96 patients, only 16 (17%) met the "load&go"-criteria. Similarly, among the 96 patients, 12 adults were treated with E-ECLS at the ED, with only 5 meeting the criteria. Among these 12 patients, favourable neurological outcome (CPC 1/2) was obtained in 1 patient without criteria.
  
  
  CONCLUSIONS
  Further promotion of these criteria within the ambulance crews is needed. May be these criteria could serve as a decision support for emergency physicians/paramedics, which patients to transport with on-going CPR to the ED for E-ECLS.
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Poppe
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Weiser
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Holzer
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Patrick
authors.initials: P
authors.lastname: Sulzgruber
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Philip
authors.initials: P
authors.lastname: Datler
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Keferböck
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Zeiner
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Lobmeyr
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Raphael
authors.initials: R
authors.lastname: van Tulder
authors.affiliation: Wiener Berufsrettung, Municipal Ambulance Service of Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ziegler
authors.affiliation: Wiener Berufsrettung, Municipal Ambulance Service of Vienna, Austria.
authors.forename: Harald
authors.initials: H
authors.lastname: Glück
authors.affiliation: Wiener Berufsrettung, Municipal Ambulance Service of Vienna, Austria.
authors.forename: Manfred
authors.initials: M
authors.lastname: Meixner
authors.affiliation: Wiener Berufsrettung, Municipal Ambulance Service of Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Schrattenbacher
authors.affiliation: Wiener Berufsrettung, Municipal Ambulance Service of Vienna, Austria.
authors.forename: Henrik
authors.initials: H
authors.lastname: Maszar
authors.affiliation: Wiener Berufsrettung, Municipal Ambulance Service of Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Zajicek
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria. Electronic address: fritz.sterz@meduniwien.ac.at.
authors.forename: Fritz
authors.initials: F
authors.lastname: Sterz
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schober
mesh_terms: D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D012042:Registries; D012189:Retrospective Studies
keywords: Cardiopulmonary resuscitation; Extracorporeal membrane oxygenation; Out-of-hospital cardiac arrest