• Tan N Doan, Stephen Rashford, and Emma Bosley.
• Queensland Government Department of Health, Queensland Ambulance Service, Brisbane, Queensland, Australia.
• Emerg Med Australas. 2024 Oct 1; 36 (5): 751758751-758.

ObjectiveExtracorporeal CPR (E-CPR) has been primarily limited to the in-hospital setting. A few systems around the world have implemented pre-hospital mobile E-CPR in the form of a dedicated cardiac vehicle fitted with specialised equipment and clinicians required for the performance of E-CPR on-scene. However, evidence of the outcomes and cost-effectiveness of mobile E-CPR remain to be established. We evaluated the cost-effectiveness of a hypothetical mobile E-CPR vehicle operated by Queensland Ambulance Service in the state of Queensland, Australia.MethodsWe adapted our published mathematical model to estimate the cost-effectiveness of pre-hospital mobile E-CPR relative to current practice. In the model, a specialised cardiac vehicle with mobile E-CPR capability is deployed to selected OHCA patients, with eligible candidates receiving pre-hospital E-CPR in-field and rapid transport to the closest appropriate centre for in-hospital E-CPR. For comparison, non-candidates receive standard ACLS from a conventional ambulance response. Cost-effectiveness was expressed as Australian dollars ($, 2021 value) per quality-adjusted life year (QALY) gained.ResultsPre-hospital mobile E-CPR improves outcomes compared to current practice at a cost of $27 323 per QALY gained. The cost-effectiveness of pre-hospital mobile E-CPR is sensitive to the assumption around the number of patients who are the targets of the vehicle, with higher patient volume resulting in improved cost-effectiveness.ConclusionsPre-hospital E-CPR may be cost-effective. Successful implementation of a pre-hospital E-CPR programme requires substantial planning, training, logistics and operational adjustments.© 2024 Australasian College for Emergency Medicine.

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