Pre-hospital ECPR: Pushing the Boundaries of Resuscitation with Nikki Hewitt

In this episode, Alec Wilding is joined by Nikki Hewitt, a clinician who has been among the first Paramedics in the United Kingdom to deliver pre-hospital ECMO as part of London’s Air Ambulance (LAA), Endovascular Cardiac Arrest Team, known as ECAT. This represents one of the most significant steps forward in resuscitation science within the pre-hospital environment, and Nikki has been at the centre of that evolution. During the conversation, Nikki guides us through the evidence base underpinning ECPR, exploring what we currently know, what remains uncertain, and how ongoing research continues to shape clinical decision-making. She also takes us inside the operational structure of the ECAT model, how the team was established, what it takes to deliver ECMO in the field, and the training, skill sets, and logistics required to make it viable outside the hospital walls. Nikki also shares her perspective on where ECPR is heading: The challenges, the opportunities, and what the future of advanced pre-hospital cardiac arrest care may look like as technology, capability, and evidence continue to advance. It is a fascinating area of practice, and Nikki brings frontline insight, experience, and clarity to a topic that is reshaping the conversation around survivability in cardiac arrest.This Podcast is sponsored by World Extreme Medicine.World Extreme Medicine provides internationally recognised education for clinicians and operators working in pre-hospital, remote, expedition, humanitarian, and high-risk environments. Their programmes focus on practical, experience-led learning, equipping professionals with the skills to make sound clinical and operational decisions when resources are limited, evacuation is delayed, and conditions are extreme.With courses covering expedition and wilderness medicine, hostile environments, dive medicine, human performance, leadership, and austere care, World Extreme Medicine brings together a global faculty with real-world experience from some of the most challenging settings on earth. To explore courses, free educational resources, and upcoming webinars, visit: ⁠www.worldextrememedicine.com