Cardiac

Retrieval of patients with cardiac emergencies makes up a large chunk of the workload of most retrieval services. Cases range from the routine to the most challenging unstable patients with complex physiology and high-level support requirements. The transfer of patients for time-critical interventions mean that the adrenaline levels of the retrieval clinician may approach those of the patient. Included are clinical and logistical considerations for patients with acute coronary syndromes, pulmonary oedema, cardiogenic shock, arrhythmias, and those requiring pacing. Aortic dissection and pulmonary embolus are also discussed in detail. With the development of smaller more portable devices the use of intra-aortic balloon pumps (IABP) and extracorporeal membrane oxygenation (ECMO) in the retrieval environment has increased. While many retrieval services routinely perform retrieval of these patients, the technology can intimidate those who do not use it regularly. The operation and key features of these devices is included.