I was still working, car mechanic,
extremely overweight.
Not a worry in the world, you know.
Came home, sitting on the couch, I started
feeling extreme jaw pain.
I waited for my wife to arrive.
She came home and saw me on the couch.
I asked her if she could drive me to the hospital.
She said no and she actually called 911.
And after they put him in the ambulance, he actually
had a cardiac arrest.
His heart stopped.
They started chest compressions on him.
His survival at that point goes way down.
Ralph came into the ER on July 28, 2010.
And Dr. Scheiner was the doctor running his resuscitation,
again doing the typical chest compressions
and airway maneuvers, drugs, shocks, the things
you've seen on TV.
Nothing was working and I happened to be in the room
assisting him and he'd gone 30 minutes of CPR, and then 40
minutes of CPR, and then 60 minutes of CPR, now we're
reaching that 60-minute point where his brain's not going to
be perfused anymore.
And so the question was can we institute this VA-ECMO
in Ralph?
And so in our hospital we had this device, ECMO machine,
that was being utilized up in the ORs and in our ICUs for
patients that had cardiac problems,
patients that had circulatory problems.
And so we started thinking, hey, maybe we
can use this in the ED.
And the problem with a lot of causes of cardiac arrest,
including pulmonary embolism or a heart attack or
a metabolic disturbance, is that it often takes a bit of
time from the time of diagnosis to the place that
gets them fixed.
And the problem there is that traditional
chest compressions, CPR, only gives us about 60
minutes max to keep perfusion to the brain, or a patient ends
up brain dead.
So what VA-ECMO, venoarterial ECMO, does is it allows us to
put a patient on a heart-lung bypass machine to take them
from the beginning of their arrest to the solution to the
problem and buys us all that time because we are now
bypassing the heart and the lungs and that's the
beauty of this.
And that was July 28, 2010, which was the beginning
of what is now become a fairly remarkable emergency
department ECMO program, which we started here
at Sharp Memorial.
In these last 10 years, we have had a whirlwind of excitement
over what we've done.
We published the first case report for ED ECMO with Ralph.
We published our first case series, which showed
five out of our first nine patients walking out
of the hospital.
In an expected survival of, you know, less than 1%,
55% is really unbelievable.
And now as I understand it, I believe there are 13 ED ECMO
centers around the country.
And then there are several ED ECMO centers that are able to
do this in Australia, Asia and Europe.
And then from just the standpoint of being involved
with something that is bigger than yourself,
something that is outside of even San Diego, for me it's
been hugely rewarding.
You know, it was a good experience at Sharp,
but it was, it's also given us an extra 10 years that we
wouldn't have had that day.
You know, it's 10 years of watching our grandsons.
Yeah, so, we both have been blessed to be with Sharp.
And that we've gotten the chance to see what innovative
things are out there for helping people.
And that he was at the beginning of that.