Patients and Family
You may be here because you or a loved one have received prehospital ECMO from the PRECARE team. We understand that encountering PRECARE may have been unexpected, overwhelming, or frightening. This page is here to help patients and families better understand the care provided, the team involved, and the purpose of this program.
If you’ve had an interaction with the PRECARE team, contact us and we will endeavour to get back to you.
Watch to learn more about the PRECARE team and pre-hospital ECMO.
PRECARE
PRECARE is a specialised medical program trial that delivers advanced life-saving care before a patient reaches hospital.
In some cardiac arrest cases, standard treatments are not enough to restart the heart. PRECARE teams are trained to provide prehospital ECMO (extracorporeal membrane oxygenation) a highly advanced form of life support known as ECPR that can temporarily take over the work of the heart and lungs when they have stopped working.
This treatment is delivered at the patient’s side, often at home or in the community, by a highly skilled team working closely with NSW Ambulance Paramedics.
ECMO does not cure the underlying cause of cardiac arrest, but it can provide critical time, maintaining blood flow to the brain and vital organs, while doctors work to identify and treat the cause once the patient arrives at hospital.
PRECARE is part of a carefully governed clinical program focused on improving survival and recovery for selected patients experiencing sudden cardiac arrest. Every case is assessed individually, and not all patients are suitable for this treatment.
FAQs
Is it ethical?
Yes. The PRECARE program has been independently reviewed and approved by a NSW Health Ethics Committee. This means the program has undergone rigorous assessment to ensure it is ethically justified, scientifically sound, and focused on patient safety, dignity, and in the patient’s best interests.
Participation in PRECARE does not replace standard emergency care. All patients continue to receive the highest level of usual treatment, and ECMO is only used when it is considered potentially beneficial and appropriate.
The program is closely monitored, with ongoing oversight to ensure patient welfare remains the priority at every stage.
Is the program cost effective?
Rest assured, there is no direct monetary cost to patients for this care. Published health economic analysis on the provision of ECPR has demonstrated that despite the expense of the procedure and hospital stay, patients who do survive go on to have long and productive lives. The PRECARE medical team provide ECPR, but they also provide advanced, hospital based interventions for patients in cardiac arrest, allowing pre-hospital teams to focus on excellent advanced life support (ALS) provision and not be disrupted with transportation.
What does it all mean – ECMO / ECPR / ECLS?
There is a lot of terminology surrounding extracorporeal life support (ECLS), essentially, it is a form of peripheral heart bypass. When ECLS is used for patients in cardiac arrest it is known as ECPR.
A large cannula (similar in style to when you give blood, but bigger) is placed via the femoral vein (near the pelvis) into the inferior vena cava (the largest vein in the body) where the patient’s blood is transferred into an external membrane oxygenator. The blood is then oxygenated and carbon dioxide is removed, a process that normally occurs naturally in the body. Blood is then pumped back into the patient via another cannula sitting in the femoral artery, returning that oxygenated blood to the aorta (the largest artery in the body). Intellectually, it makes sense – technology that can bypass the heart and provide adequate perfusion to the brain and other vital organs is the perfect treatment for someone in cardiac arrest.
ECPR essentially ‘stops the clock’ allowing time for the cause of the cardiac arrest to be treated, often that involves interventional coronary angiography in hospital. A cardiac arrest will not stop until the cause of the arrest has been treated, and ECPR does not treat any of the underlying causes of cardiac arrest.
Who makes up the PRECARE team?
The PRECARE team is composed of 2 senior aeromedical specialist doctors and a critical care paramedic. This team has been trained specifically to provide ECPR in the prehospital environment for the PRECARE trial. The team is based in Homebush, using a rapid response vehicle.
What is the cost of the trial and how is it funded?
The cost of consumables to perform ECPR are approximately $10,000 per patient. This does not include a patient’s hospital stay. None of the PRECARE associated costs are passed on to the patient. The trial is sponsored by NSW Ambulance and supported with in-kind support by Westmead Hospital and RPA Hospital. The trial is also supported by GE Healthcare, Australian Blood Management. The trial received a Greenlight Foundation research grant and a NSW Health research grant. Funding for the PRECARE trial program currently runs until June 2026, it’s future after this is uncertain.
PRECARE 