Violet Code: From “Stay and Play” to the new concept “Stay Not Much and Run!” An ECLS OHCA pilot study by Helicopter Emergencies Medical Service

Purpose: The Stay and Play concept in a OHCA (out of hospital cardiac arrest) shows a survival rate from 4 to 10%. Recent non-randomized studies of ECLS (extracorporeal life support) in OHCA suggested a new concept of “Stay not much and Run” with a survival rate of 30%. We present the results from 2015-2018 of our OHCA protocol (Violet Code-VC) assessed in Pieve di Cadore (Belluno), a north Italian Helicopter Emergency Medical Service (HEMS) base. Nine patients were transported directly to a cardiac centre with mechanical chest compression device LUCAS 2 (Lund University Cardiac Arrest System, Physio-Control, Sweden) under ongoing CPR (cardiopulmonary resuscitation). Five of these patients met the inclusion criteria of the “Violet Code” and an ECLS was started.