For the first time in Israel: a new ambulance that will allow cardiac arrest patients to be connected to ECMO in the pre-hospital setting

30-07-23

The combined team of Magen David Adom and the Shamir Medical Center - Asaf Harofeh, which includes paramedics, nurses and doctors - began operating only recently, and has already saved the lives of several patients who suffered cardiac arrest. In this way, Magen David Adom joins other countries such as the Netherlands, Great Britain and the United States that already use the ECMO procedure in the field in order to save lives.

Before the integrated team began to operate, patients who went into cardiac arrest and underwent unsuccessful CPR in the field - were taken to the hospital if possible while CPR continued, where they were connected to an ECMO (cardiopulmonary) device in order to stabilize their condition. In recent months, MDA paramedics and nurses and doctors from the Shamir Medical Center have undergone special training for handling the ECMO procedure already in the field, thereby significantly shortening the time of connection to the device and saving lives in moments when every minute is critical.

At the end of June, a 45-year-old man collapsed and lost consciousness while working in Bnei Brak. MDA medicycles, a mobile intensive care unit (MICU) and also the new ECMO team operated in cooperation with the Shamir Medical Center - Assaf Harofeh were rushed to the scene. The MICU team performed CPR which included giving electric shocks using a defibrillator and began evacuating him to the hospital, when his condition was on the way The man's condition began to deteriorate. The team of the MDA ECMO mobile and the Shamir Medical Center - Assaf Harofeh joined the MICU that evacuated the patient, and the complex procedure of connecting to the ECMO was carried out in field conditions.

The next day, the man woke up in the hospital, without neurological damage: "I remember going to work and then waking up in the hospital and I didn't understand what I was doing there. I was told that I was actually already in the next world, and thanks to the angels of MDA who arrived very quickly and in combination with the ECMO ambulance that reached me with the combined MDA Shamir Asaf Harofeh hospital team, I was rescued in the field and my life was saved. I am happy and blessed that with God's help I returned to my family, my dear wife and my three children. It is simply a miracle. I was very excited when I realized that what saved my life was the new mobile that came to me and connected me to the ECMO machine and from there to the catheterization room. I hope that this project will expand to the whole country and thus they will be able to save many more lives."

"The team's arrival at the scene of the incident is made possible by a special vehicle that is equipped with the latest medical equipment," explains MDA Deputy Director General of Operations Gil Moshkowitz, "These days we are characterizing a unique vehicle that will be used by the team as an 'operating room on wheels', with which they can perform even more complex procedures outside the hospital walls. The state-of-the-art German-made Mercedes-Benz Sprinter type vehicle will have a working environment adapted to the needs of an operating room for the medical procedure. The ambulance will include full MICU equipment, a unique electric bed suitable for seriously ill patients, a special place for accompanying the patient and even a special medicine refrigerator. The ambulance includes space for a driver, five crew members and a patient.'

The ECMO Ambulance project is led by MDA Deputy Director General of Medicine Dr. Raphael Strugo, alongside MDA Medical Division Director Rami Miller and his deputy Tomer Kaplan, in cooperation with Dr. Eduard Ilgiyaev, Director of Intensive Care Unit Shamir Medical Center and Dr. Gal Pachys Director of the Department of Emergency Medicine Shamir Medical Center.

Dr. Gal Pachys Director of the Department of Emergency Medicine Shamir Medical Center: "It has been a great privilege for me to be a part of leading the revolution in the field of CPR in Israel. Although changes and updates have been made in this field in recent decades in Israel and throughout the world, despite these updates, the rate of survivors of out-of-hospital cardiac arrest is persistent and remains below 5% in Israel."

Dr. Eduard Ilgiyaev. Director of Intensive Care Unit Shamir Medical Center: "The connection to ECMO in the field before arriving at the hospital is intended for patients suffering from cardiac arrest who are resistant to conventional treatments. The Shamir Medical Center (Assaf Harofeh) is proud to be the first pioneering institution in the Middle East to offer this exceptional service for its population. This service was made possible only thanks to the efforts and collaborations of MDA, the emergency medicine department, the cardiology unit and general intensive care unit. Only through the strong cooperation of all involved, this extraordinary service came to fruition. The implementation of this respectable and important service requires significant resources and complex logistical arrangements. In the face of some opposition from some respected professionals, I firmly hold my unwavering faith in the program's winning results. This project has the potential to become one of the most important at the national level in the field of saving lives in Israel."

Dr. Refael Strugo, Deputy Director General of Medicine at Magen David Adom and who initiated and led the new service: "I am hopeful that in the future we will expand the project to additional hospitals, on the way to saving lives in other places nationwide. In the end, we are talking about budgets, resources and manpower - but we are looking at the end of the process at a 45-year-old father who returned to his family, after almost saying goodbye to the world. This is the real power."

Eli Bin, MDA Director General: "With the help of technology, professional resources and advanced medical tools that were allocated to the Akemo project in collaboration with Shamir Assaf Harofeh Hospital - we have proven that it is possible to save lives, even in the most difficult and complex resuscitation cases and turn a dangerous and medical emergency into a situation that ends with a smile".