A 45-year-old Bnei Brak man last month experienced two clinical death episodes and lived to tell about them thanks to a joint lifesaving initiative by Magen David Adom and Shamir Medical Center that put a heart-lung bypass machine on an ambulance.
On June 27, the man went into cardiac arrest in an art gallery in Bnei Brak. The key to his survival was the fact that he received initial CPR from a civilian and that EMTs arrived in minutes, ensuring his organs received oxygen even though his heart was not beating.
Within one minute-and-50 seconds of the patient’s collapse, the person who called MDA was performing CPR under the MDA dispatcher’s direction. Within three minutes of the call, MDA first responders were at the scene administering cardiac shocks from a defibrillator to restart the man’s heart.
And within five minutes, an MDA MICU unit was at the scene, initiating the patient’s transfer. At the same time, a second ambulance, a special ECMO (extracorporeal membrane oxygenation) unit equipped with a heart-lung bypass machine that MDA and Shamir Medical Center installed several months ago, also raced to the scene.
Soon after the MICU team initiated the transfer, the patient’s heart stopped for a second time and MDA decided to transfer him to the ECMO ambulance, providing him with a better chance of arriving at the hospital with his brain and organs fully oxygenated.
The MDA team pulled the man from the MICU ambulance and took him to a nearby ceramics store, where the owner allowed them to use his floor space as a medical staging area for the ECMO machine.
After the patient was put on the ECMO machine, which was now replacing his heart and lungs, he was loaded into the ECMO ambulance and rushed to the catheter lab at Shamir Medical Center, where he underwent angioplasty.
He regained consciousness the next day, looking amazingly well, and recorded a thank-you video to MDA for saving his life.
“I remember going to work and then waking up in the hospital and I didn’t understand what I was doing there,” he said. “I was told I had already been in the next world, and thanks to the angels of MDA and Shamir Hospital team, my life was saved.”
The ECMO unit installed on an ambulance is a game-changer, according to Dr. Shafir Botner, senior paramedic and head of MDA’s paramedic training program. This makes Israel one of the few countries in the world — along with the United States, Britain, France, Australia, and the Netherlands — using ECMO technology outside a hospital setting.
“It buys the paramedics time, enabling them to work smartly and without the sense that time is ticking away because they know they don’t have to worry about the patient’s brain and other organs being deprived of oxygen,” Dr. Botner said.
“It has been a great privilege for me to be a part of leading the revolution in the field of CPR in Israel,” said Dr. Gal Pachys, director of the Department of Emergency Medicine at Shamir Medical Center. “Although changes and updates have been made in this field in recent decades in Israel and throughout the world, the rate of survival for out-of-hospital cardiac arrest is persistently low and remains below 5% in Israel.”
Innovations like the ECMO ambulance could make survival rates for cardiac events appreciably higher.
Since that incident in Bnei Brak, several other patients have been saved with the ECMO ambulance — all with seemingly good outcomes so far.
“Magen David Adom is looking at designing an even more advanced vehicle that can perform even more complex procedures outside hospital walls to save even more lives,” said Gil Moscowitz, MDA’s deputy director-general for operations.