District of Mirandola
A day dedicated to the simulation-training of the rescue teams, testing an innovative ECMO extracorporeal circulation system in a mountain environment
Timeliness and effectiveness of advanced rescue services, even in an impervious environment. These are the objectives of the exercise scheduled for Friday 17 March on Monte Cimone.
Thanks to the collaboration between the 118 Emilia EST Operations Center, the Bologna and Pavullo helicopter rescue services, the Monte Cimone station of the Emilia Romagna Alpine Rescue, the Monte Cimone Piste rescue, the Passo Del Lupo carabinieri and the 118 territorial emergency the “Mountains and Rescue in the Apennines” initiative was born in Modena: two days dedicated to mountain rescue, during which experts in the sector discussed intervention protocols to improve the efficiency and effectiveness of rescue in extreme conditions .
The focus was on the treatment of severe accidental hypothermia and its extreme consequences, ie cardiac arrest and subsequent death. Although this condition is not frequent, it can occur in particular environmental conditions: in winter in the mountains, associated or not with particular events such as avalanches.
- The SET 118 group of Modena
The simulations that took place on the slopes of the Cimone consortium envisaged the search and rescue of three ski-mountaineers: a hypothermic with severe trauma, a II degree hypothermic with trauma and a third hypothermic cardio-respiratory arrest patient due to which the use of an innovative ECMO extracorporeal circulation transportable system was tested. The 3 simulated patients were rescued in an impervious environment thanks to the collaboration between Alpine Rescue, Cimone Piste Rescue and the Carabinieri also with the use of the Pavullo helicopter rescue, still the only helicopter rescue in the region capable of operating in impervious environments.
The Bologna air rescue team, which subsequently landed at Passo del Lupo, tested, in a completely innovative way, the use of a transportable ECMO extracorporeal circulation system directly in the field, to intervene on the patient in hypothermic cardiac arrest. The rescue intervention scenario finally ended with the simulated transport to one of the two regional reference centers for the treatment of these patients which – in our region – are the Cardio Surgery and Cardio Anesthesia of the Maggiore Hospital of Parma and the Policlinico of Sant’Orsola of Bologna.
The extracorporeal circulation system (ECMO) is a technology that can guarantee cardiovascular support and gradual warming of the patient which, as widely reported in the literature, allows the survival of patients suffering from severe hypothermia in cardiac arrest.
Scientific and technological evolution today is capable of making these advanced rescue systems ever lighter and therefore more portable. However, their use requires education, competence and training and the tested simulation tool can guarantee maximum performance results.
Today’s experimentation is also the result of a specialization process started some time ago by the Bologna 118, relating in general to complex equipped transport, including those with ECMO on long-distance wheels. The first intervention of this type in the Region took place in 2011, during the transport of a patient with very serious respiratory failure from the H1N1 virus. Then the 118 team of
Bologna carried out for the first time the transport of a patient assisted with the ECMO to the Policlinico di Sant’Orsola.
Today’s training-simulation was therefore an opportunity to consolidate and acquire new skills on the part of the 118 medical-nursing staff of the Local Health Authorities of Bologna and Modena.
At the same time, the interaction with the various technical rescue bodies has allowed the Emergency professionals of the Ospedale Maggiore of Bologna to test complex rescue maneuvers in an impervious environment, being able to count, among other things, on the consolidated experience with the Simulation Center Gambale, used precisely for continuous training.
The commitment of emergency professionals therefore continues to guarantee advanced medical assistance brought directly to the patient in every place in the region, at any time of the day, thanks to the growth in clinical training and the daytime and nighttime operational developments of the aircraft.
Last update: 17 March 2023