We present inclusion and exclusion criteria and a comprehensive, detailed, generalizable list of best practices for extracorporeal cardiopulmonary resuscitation (ECPR) initiation following refractory out-of-hospital cardiac arrest (OHCA), systematically identified by an international panel of content experts.

These findings may assist centers with established ECPR programs by aiding simulation training and quality improvement practices as called for by previous consensus statements, and serve as a template for centers developing new ECPR programs.

Snowball sampling generated a panel of 14 content experts, composed of physicians from four continents and five primary specialties.

7 existing institutional protocols for ECPR cannulation following OHCA were identified and merged into a single comprehensive list of 207 items.

The panel reached consensus on 101 items meeting final criteria for inclusion: Prior to Patient Arrival (13 items), Inclusion Criteria (8), Exclusion Criteria (7), Patient Arrival (8), ECPR Cannulation (21), Go On Pump (18), and Post-Cannulation (26).

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