automated cpr

Juxel

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We use the Lucas Device in the hospital but in the field still do manual compression. There is some debate about these devices causing harm to patients:. It does burn through compressed air very quickly, which is a potential downside to using it in the field.
 

PapaBear434

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Wow... Another piece of equipment to carry and keep a battery (or compressed air) charged for!

The only real use I can find in the field for this is that short period of time of trying to get the stretcher out of the back and into the ER. But have someone just ride on the side of the stretcher and it does about the same thing.
 

tydek07

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Huh' have not seen that one before... They keep coming out with these devices and they have yet truly "caught on". Does this say something?
 

reaper

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Yes, It says that we are not truly looking at the benefit of their use!
 

stephenrb81

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There are a couple of services around my region that use similar devices. Some models can also link with some of the computerized run-sheet systems and defibrillators so vitals, CPR, marked-events on the monitor, etc.. are all automatically appended to the trip sheet (I'm thinking Zoll systems, but not entirely sure.)

I hear mixed reviews from people that have personally used them. Some love them and swear by them. Some complain that they have to be reset alot (apparently a safety system that stops it if the bands slip or slides on the torso).

I have personally seen one used once when I had requested an ALS intercept from a neighboring county. My arms were glad to see it of course and once the medic set it up, it never once stopped/locked-up. But I'm sure mileage will vary.


EDIT: I have also heard that some argue that the machine's compression are better than manual compressions because the machines actually "squeezes" the chest offering better perfusion compared to the standard "push down" compressions. I have not been presented with any material substantiating that, just throwing it out there for consideration/debate.
 
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waemt09

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all the articles say it can deliver up to 80 pumps per minute for up to an hour.. the only benefit I see from carrying it along with the thousand other things on my rig I never use would be for a long transport that would require continuous CPR. Then it would be a huge benefit to everyone I think. One would assume the machine won't get fatigued and stop performing as it did at the start.
 

reaper

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It also won't stop compressing while going through a doorway, loading the pt, hitting a pothole, and taking sharp corners!

All codes should be worked at the scene. But for services that transport codes, they should be mandatory equipment.
 

Linuss

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Maybe I missed something... but how would an AEDbe used with that on?
 

Hockey

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Maybe I missed something... but how would an AEDbe used with that on?
Very carefully ;)

Was wondering the same thing though

Saw this device a week or so ago and thought it is great, but with a price tag it has, I don't see many services having it...
 

marineman

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The device in that video is the Zoll Autopulse. The service I ride with is one of 3 or 4 (i forget right now) study areas in the U.S. (I think Houston fire is one too). We have completely different PNB protocols for areas that the study is in effect. I've talked about it in another thread and discussed the comparison between this and the Lucas with one of the more experienced members in a thread in the Equipment area I believe.

Works well, yes it automatically shuts off if the band slips down. Even a magical CPR machine does no good compressing the abdomen. The newer update machines do 100 compressions per minute, the old ones were set at 80. Several people have stated it's just more equipment, if either of the devices are able to provide better CPR than I am at all then I'd say it's a fantastic piece of equipment since all the drugs in that drug bag that you don't complain about, and that fancy 12 lead monitor won't save a life without quality CPR.

Edit: AED is used like normal, place pads before securing the "life band" and zap 'em. Unit is automatically set to do 30-2 for 3 minutes then will automatically pause so you can have an AED analyze or for the manual type folks out there you can check your underlying rhythm and shock if needed then hit the resume button and away it goes for another 3 minutes

Not only does it save me the effort of doing CPR and potentially provide more adequate CPR but now we're free to do those other fun skills that will add to the benefit rather than just pounding on the chest all day. We used to always bring a first responder in the rig to do compressions en route but with this we can leave them behind and have more room to move in the rig while doing other procedures. They do have some trouble points that are slowly being fine tuned and we'll have to wait and see what the study results say but considering every ambulance and every fire engine in our area got an autopulse put on it for free ($24,000 each) I'm ok with carrying it to save some work in the long run. We've never run long enough to test the batteries but the ones we're using (always have newest models) are said to last closer to 3 hours on continuous mode.
 
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waemt09

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that other one looks kind of scary. lol.. something like you'd see in moving smashing someones head in, but that's how we all compress so why mess with that. I would suggest reading the studies on these machines. They say it is a very valuable thing to have. What is the price tag on these? My only skepticism with this machine is it will make EMT's not necessarily lazy, but I can see some will relying on it solely as their only CPR option and never want to perform the real deal cpr.
 

tydek07

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I guess I do not forsee these becoming widely used in EMS... at least not for awhile.

The biggest concern of mine is that they appear to get in the way. How would you listen to lung sounds easily? Pt has a pneumo and you decompress, no longer can use this device. As other have mentioned, how would the pads (defib) effect it? And for those services out there that still use the paddles... hmm, in the way yet again.

They just appear to be more of a pain then anything. Would they be nice to have, yes... if there were not so many negatives on them right now.

Take Care,

***EDIT: I am talking about this specific device, the wrap around type. As, I have seen others out there that cover up less of the chest, therefor leaving more expossed for defib, lung soungs, etc etc.
 
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PapaBear434

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Yeah, I don't like this still. My department has a lot of people, so there are plenty of people on hand during a code to trade off compressions. I could see it being handy for long transports, but there are hospitals no more than fifteen minutes away from almost anywhere in my area...

So, I guess it would be great for small EMS departments with fewer people and longer distances between hospitals, but those people that could actually use it most are the least likely to afford it.

Good idea, not that practical.
 

marineman

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One more time, Defib works exactly the same. You put patches on before securing the life band on the zoll. 1 button push and the life band comes loose enough that you can listen to the lower lobes of the lungs. Never seen a decompression done while using the autopulse so I don't know if the band would mess up the cath after or not. They aren't for everyone but most people that have used them love them. The lucas is apparently just as good or better but I have no experience with it.

Yeah, I don't like this still. My department has a lot of people, so there are plenty of people on hand during a code to trade off compressions.
How many people do you want to be tripping over in the back of the rig if you do transport a code? Ours keep getting smaller and smaller every time they get new ones so less people is definitely a good thing.
 
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PapaBear434

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We usually have three people in the back, one driving. Two medics, one BLS to do compressions/bagging. That way, only one medic is tied up doing the "regular" work of CPR and the other is free to play with all the fun drugs.

It works out pretty well, actually.
 

marineman

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that's what we used to do but our new rigs are city medix mini mods that have the cot against the wall and no CPR seat. only the jumpseat and the bench. no room to get by someone doing CPR if needed. As long as you have an effective system no need to change it but the Autopulse works great for us.
 

bowulf

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We are actually starting a 1 or 2 month demo of the same device as well. Our unit should be here in 2 weeks, and the Lucas rep should be here to with our medical director to write temporary standing orders for the medics.
 
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