ECPR Dr. Anson Cheung, left, emergency physicians, perfusionists, respiratory therapists, nurses, fellows and assistants take part in an ECPR simulation session in St. Paul’s Teck Emergency Centre

First-in-Canada: ECPR Simulation Program

Promise Magazine: Fall 2017

Photography by Brian Smith

Bi-weekly simulations help emergency teams keep their ECPR skills in top shape

Dr. Jeanne MacLeod, an emergency physician and director of simulation for the St. Paul’s emergency department, gained insights into the value of simulation exercises thanks to her brother-in-law, a pilot, who informed her that in commercial aviation, when a pilot takes off a certain amount of time, simulation exercises are a must. Otherwise, you don’t fly.

Following maternity leave, MacLeod felt she would have benefitted had a simulation program like the one she leads today been in existence at that time. “I had been off for nine months and it was still fairly early in my career. Simulations would have been a great way to help me brush up on my skills and return to work in a more measured way,” says MacLeod.

Today, MacLeod’s leadership in the field of emergency simulation, along with support from colleagues who share her view that simulations are an invaluable educational resource, sees St. Paul’s assuming an influential role. A major achievement has been a first in-Canada ECPR simulation program.

ECPR Simulation Program 

The 30-minute ECPR simulation program sessions run once a month in St. Paul’s Teck Emergency Centre, allowing health care workers to train together in a safe environment.

ECPR (extracorporeal cardio-pulmonary resuscitation) is a process in which a cardiac arrest patient’s blood is circulated through an external device, an ECMO machine (extracorporeal membrane oxygenation), that continues to pump and oxygenate the blood while physicians work to pinpoint the cause of the cardiac arrest – and get the patient’s heart started again.

MacLeod says there may be up to 14 people involved in the ECMO stage of ECPR. “It’s kind of like a pit crew in auto racing. There are profusionists, emergency physicians, a respiratory therapist, nurses, a cardiac surgeon, fellows, assistants. Everyone has a role to play, time is of the essence, and we are working in a very confined space.”

MacLeod and her colleagues are already looking forward to the new St. Paul’s site and having a designated space for simulations – not just for emergency, but for maternity, ICU and other areas.

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