World-leading medical technology saves the life of Brighton dad

Ambulance Victoria in partnership with The Alfred has delivered world-leading medical care to a Brighton living room, performing emergency surgery inside the family home to save the life of a father in cardiac arrest.

Peter, 56, is alive today thanks to treatment with a complex portable heart-lung machine, known as extra-corporeal membrane oxygenation (ECMO), normally reserved for use only in hospital operating theatres and intensive care units.

The ECMO machine replaces the function of the heart and lungs, allowing blood to be pumped outside the body, removing carbon dioxide and sending oxygen-filled blood back into the body.

Initiating the treatment saw the intensive care specialists from The Alfred perform emergency surgery on Peter on the floor of his lounge room, working alongside an Ambulance Victoria paramedic to insert large tubes, called cannulas, into major blood vessels and connect the life-saving ECMO machine.

Ambulance Victoria Executive Medical Director Assoc. Prof. David Anderson said it is revolutionary to be able to offer this life-saving intervention out of hospital.

“Melbourne was the first city in Australia and one of only a handful around the world where pre-hospital ECMO is being delivered. Peter was the 41st patient in Melbourne to receive ECMO treatment at home,” David said.

“Highly skilled ECMO teams are bringing cutting-edge technology from the hospital intensive care unit directly to patients in life-or-death situations, delivering critical care faster and potentially giving more patients a better chance of survival and recovery.”

The prehospital ECMO team is made up of an Ambulance Victoria paramedic and two specialist intensive care doctors from The Alfred.

The extraordinary treatment is currently being trialed in the pre-hospital environment in Melbourne by Ambulance Victoria and The Alfred, testing its life-saving impact.

ECMO can be delivered to cardiac arrest patients where first responders have been unable to get the patient’s pulse back after 20 minutes or more of high-quality cardiopulmonary resuscitation (CPR).

“These patients typically have an extremely low rate of survival – Ambulance Victoria research shows only around four per cent survive. But research around the world has shown treatment with ECMO at the scene could increase survival rates to around 30 per cent, and that’s what we’re now testing right here in Melbourne,” David said.

Cardiac arrest survivor Peter’s wife Katie and son Harry began CPR when he collapsed one morning in March this year. Firefighters and Ambulance Victoria paramedics were quickly on scene at the family home, continuing compressions and delivering nine shocks with a defibrillator before Peter’s pulse returned.

“What followed was extraordinary. Because of the circumstances of Peter’s cardiac arrest, a cardiac bypass team from Ambulance Victoria and The Alfred came to our house and placed him on ECMO in our lounge room before transporting him to hospital,” Katie said.

“They even picked up where the blockage was in Peter's heart, so when they arrived at hospital, they had the Cath Lab ready and waiting for him.

“It was incredible to witness the level of pre-hospital emergency care now possible.”

Use of ECMO in the pre-hospital setting is being researched through the CHEER3 trial (CPR/pre-Hospital/ECMO/Emergency Reperfusion trial 3), with funding from The Alfred Foundation and Ambulance Victoria.

“Victoria is home to some of best medical specialists in the world, which allows us to utilise advanced medical equipment like ECMO and deliver ground-breaking research,” David said.

“Peter’s story showcases the result of a world class system coming together to save a life – early bystander recognition of cardiac arrest and CPR, the Emergency Medical Response (EMR) partnership with Fire Rescue Victoria which sees firefighters dispatched alongside paramedics to the most critical medical cases, and world-leading pre-hospital treatment by our paramedics and doctors.”

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