Saved by the pump: Two successful resuscitations utilising emergency department-initiated extracorporeal cardiopulmonary resuscitation in South Africa

In 2021, the three basic pillars of modern cardiac arrest management are still high-quality closed chest compressions, early defibrillation of shockable rhythms, and prompt recognition and treatment of potential reversible causes of cardiac arrest. The reversible causes are commonly known and taught as the ‘Hs and Ts’, namely hypovolaemia, hypo/ hyperkalaemia, hydrogen-ion/acidosis, hypoxaemia, hypothermia, thrombosis (coronary), thrombosis (pulmonary), tamponade, tension pneumothorax, and lastly toxins.[1,2] Walter Kloeck[3] described a popular, practical 10-step approach using a zig-zag technique during examination to find these reversible causes.

N Vlok,1 MB ChB, Dip RTM (RCSEd), Dip PEC (SA); K A Hedding,1 MB ChB, Dip PEC (SA); M A van Dyk,2 MB ChB, FCA (SA), Cert Crit Care (SA), PG Dip Clin Ultrasound (Melbourne)

1 Emergency medical officer, private practice, Pretoria, South Africa
2 Specialist anaesthesiologist and intensivist, private practice, Pretoria, South Africa

Corresponding author: N Vlok (

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