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How should we approach ECPR cannulation in IHCA? On-site cannulation or intra-arrest transport to the cath lab? 📸Training our ECMO Barcelona team on on-site cannulation with in-situ simulation at Vall d'Hebron #ECPR #ECMO #IHCA #InSituSimulation

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Two weeks ago, I shared one of the hardest cases our team faced — a young father with an out-of-hospital cardiac arrest, nearly 30 minutes of downtime, profound acidosis, Lactic acid 12, PH 7.0, refractory VF, and profound cardiogenic shock. Statistically, survival in these situations is rare. Out-of-hospital cardiac arrest carries mortality approaching 90%. Today, he walked into my office. Alive. Smiling. Grateful. He even walked across to personally thank my cath lab team who fought for him 💚 First and foremost, all thanks and glory to GOD 🙏 🎯 There are moments in medicine where we do everything we can — and the final outcome is not entirely ours to decide. 👉This was not the work of one person. It was a SYSTEM : • A bystander who acted • Early AED use ‼️ • An extraordinary EMS field crew • A coordinated ED, cath lab, and ICU team • The Emory ECMO team for escalating MCS support. Modern medicine saves lives in the hospital — but survival from cardiac arrest starts in the community! 🎯 With STEMIs in cardiac arrest, time is not just muscle… it is neurons. What makes this even more meaningful & inspiring is that this patient is now working to expand AED availability in his community. 👉That is how lives multiply. One survivor becomes an advocate. One saved life becomes many future chances. To our EMS teams especially — thank you for starting the chain of survival. Moments like this remind us why we do what we do. Piedmont Emory University Johnson & Johnson MedTech | Heart Recovery Heart Attack Ethiopia, Inc. (Shared with patient’s permission)

Tesfaye A. Telila MD, FACC,FSCAI.

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