{
  "abstract": "Advanced vascular access skills are an essential component of all critical care specialty curricula. However, common femoral artery (CFA) cannulation and sheath insertion has thus far not been emphasised within emergency medicine training. The advent of life-saving endovascular resuscitation techniques in both medical and traumatic disease, along with the inherent advantages of central arterial pressure monitoring in the severely haemodynamically compromised patient, mandates the prioritisation and deliberate practice of this procedure.CFA access facilitates central invasive arterial pressure monitoring as well as Seldinger-guided sheath insertion through which a number of resuscitation devices may be inserted further into the arterial system and left heart—termed ‘endovascular resuscitation’. Arterial line placement is considered core to emergency medicine training by Australasian College for Emergency Medicine (ACEM) and Royal College of Emergency Medicine (RCEM), but this is not specific to the skill of CFA access. Extracorporeal Membrane Oxygenation (ECMO) CPR is likely to become increasingly common in refractory cardiac arrest. ECMO is listed as a scope of practice skill for emergency medicine by ACEM. ECPR is now an American Heart Association (AHA) Class 2 recommendation for cardiac arrest. The ELSO registry reports indicate a steady increase in ECPR globally in the last 5 years. ECMO technology development and increasingly procedural and indication refinements will also likely mean this intervention will become simpler to perform and manage. There is an increasing focus on perfecting this skill prior to embarking on training programmes for endovascular resuscitation or ECPR in both the prehospital and in-hospital emergency medicine environment. We describe the key technical steps in performance of this procedure, discuss acquisition and maintenance of competency, and describe pitfalls. CFA access in emergency medicine has an increasing relevance to practice. It is imperative that this procedural skill is given diligence in training, process, governance and relevance to emergency medicine practice.",
  "authors": [
    {
      "affiliations": [
        "Aeromedical Operations, Ambulance Service of NSW ACE Training Centre, Bankstown, New South Wales, Australia",
        "Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Brian Burns"
    },
    {
      "affiliations": [
        "Aeromedical Operations, Ambulance Service of NSW ACE Training Centre, Bankstown, New South Wales, Australia"
      ],
      "name": "Natalie Kruit"
    },
    {
      "affiliations": [
        "Cardiology Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"
      ],
      "name": "Mark Dennis"
    },
    {
      "affiliations": [
        "Emergency Medicine, Sharp Memorial Hospital, San Diego, California, USA"
      ],
      "name": "Zack Shinar"
    },
    {
      "affiliations": [
        "Interventional Cardiology, Saint Bartholomew’s Hospital Barts Heart Centre, London, England, UK"
      ],
      "name": "Paul Rees"
    },
    {
      "affiliations": [
        "Vascular Surgery, Royal North Shore Hospital, St Leonards, New South Wales, Australia"
      ],
      "name": "Shen Wong"
    },
    {
      "affiliations": [
        "Department of Cardiothoracic surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"
      ],
      "name": "Brian Plunkett"
    },
    {
      "affiliations": [
        "Aeromedical Operations, Ambulance Service of NSW ACE Training Centre, Bankstown, New South Wales, Australia"
      ],
      "name": "Cliff Reid"
    },
    {
      "affiliations": [
        "Manchester Academic Health Science Centre, Manchester, England, UK"
      ],
      "name": "Simon Carley"
    },
    {
      "affiliations": [
        "University of Minnesota, Minneapolis, Minnesota, USA"
      ],
      "name": "Demetris Yannopoulos"
    }
  ],
  "title": "Common femoral artery access in emergency medicine",
  "uid": "f5a985f0-38f6-59bb-a001-588fc48a9c2a"
}