Res-Q-Pods

Sasha

Sasha

Forum Chief
Messages
7,667
Reaction score
11
Points
0
I've recently been curious about Res-Q-Pods, so decided to do some reading. Anyone familiar with them? Does your service use them? Do you feel they successfully contribute to a ROSC? Do you feel they're a pointless waste of money? I've heard, anecdotally, that they are expensive. The website claims it improves circulation to the heart and brain.

Here is something from the website explaining how it works.
The ResQPOD prevents unnecessary air from entering the chest during CPR. As the chest wall recoils, the vacuum (negative pressure) in the thorax is greater. This enhanced vacuum pulls more blood back to the heart, doubling blood flow during CPR. Studies have shown that this mechanism increases cardiac output, blood pressure and survival rates. Patient ventilation and exhalation are not restricted in any way.
Click to expand...

So, is it kind of like a reverse PEEP, in a way?

And a study showing improved results with the use of an ITD device.

Full study can be found Here
Methods:
ITD use was implemented by the Staffordshire Ambulance Trust, which treats 1600 cardiac arrests per year with 90 advanced life support (ALS) units and an average response time of 6.3min. During training, rescuers learned to use the ventilation timing lights to discourage hyperventilation. Rescuers applied the device after tracheal intubation. They were trained to allow the chest to recoil fully after each compression. Prospective ITD use in adults receiving conventional manual CPR for non-traumatic cardiac arrest was compared to matched historical controls receiving conventional manual CPR without inspiratory impedance. All received similar ALS care. The primary endpoint was admission to the emergency department (ED) alive following cardiac arrest. Chi-square, Fisher's exact and Kolmogorov–Smirnov tests were used for statistical analyses.

Results:
Survival (alive upon ED admission) in all patients receiving an ITD (61/181 [34%]) improved by 50% compared to historical controls (180/808 [22%]) (P<0.01). Survival in patients presenting in asystole tripled in the group receiving an ITD (26/76 [34%]) compared with historical controls (39/351 [11%]) (P=0.001). There were no significant adverse events.
Click to expand...
 
I was trained on them back in Michigan, but as a BLS crew never got to use them. As part of a national study we were given a bag at the beginning of each shift and were not allowed to open it until we worked the call. Some had pods, others didn't. I never stayed there long enough to see or hear any results, but the concept makes sense.
 
Very Cool idea, if they work as well as suggested it would be amazing. I dont see myself as BLS provider using them often enough to justify the expense. Way cool otherwise.
 
MMiz said:
I was trained on them back in Michigan, but as a BLS crew never got to use them. As part of a national study we were given a bag at the beginning of each shift and were not allowed to open it until we worked the call. Some had pods, others didn't. I never stayed there long enough to see or hear any results, but the concept makes sense.
Click to expand...

I'm curious on how they randomized the bags. Was there any method to who got what bag (e.g. each bag had a number and someone rolled dice to determin which bag), or was it just what ever bag you got handed that day?
 
JPINFV said:
I'm curious on how they randomized the bags. Was there any method to who got what bag (e.g. each bag had a number and someone rolled dice to determin which bag), or was it just what ever bag you got handed that day?
Click to expand...
Our trial included the ResQ pods and ResQ pumps (a toilet plunger like device with a metronom). If we worked a cardiac code we would pull our sealed nylon bag, which would include either:

1. Rescue Pod w/ BVM
2. Rescue Pump w/ BVM
3. Rescue Pump/Pod w/ BVM

We then called a 24/7 number after the code and answered a whole bunch of questions. It was part of an ongoing research study. To answer your question, it was simply by what bag you got that day.
 
Is the RescuePump different from the Ambu CarioPump? I know the FDA refused to test the CardioPump, as recently as 2003. I have used it in Israel, and while it is more tiring, provides much higher quality CPR.
 
My service just bought a box of 10 for trial. $99 a piece, and they are a one time use item. Sounds crazy but we average 4 or 5 codes a year, so we don't need too many.
 
The service in the county just north of me uses them. My cardiac instructor works up there and doesnt seem to be pleased with them. In theory it sounds like a good idea though
 
If I had $1 for every EMS gimmick that was "good in theory" I would be able to single handedly fund the research for the cure for cancer.
 
emt.dan said:
Is the RescuePump different from the Ambu CarioPump? I know the FDA refused to test the CardioPump, as recently as 2003. I have used it in Israel, and while it is more tiring, provides much higher quality CPR.
Click to expand...
Yes, it is the same product. We used them in a trial in 2005, and it appears as though the trial is ongoing.
 
We use them on every code. The difference in ROSC was very noticable! They run about $60 each, but to me are worth the effort. Biggest thing you have to remember is to remove it, as soon as you gain ROSC!

We look at getting rid of them, due to cost only. Then AHA moved them up the ladder of suggested use. That made admin rethink the decision and they stayed on the truck.

If you check pulses while using one, you will feel the difference. The pulse will be stronger with compressions and res-Q-pod, then with out it. I for one am a believer in them!
 
There is a ResQPod trial going on in Indy right now. Our service isn't part of it, but we still have to submit cardiac arrest info even though we don't have the random bags on our trucks.
 
We have what I suppose you could call a mandatory trial with the Res-q-pod, in that we are mandated to use them on all intubated arrests.

I had an ROSC from a PEA arrest a few weeks ago, but would be lying if I said it was all down to the pod. Possibly more to do with CPR being done from the outset, as it was in a healthcare facility.

Any feedback I have heard has been encouraging, but numbers are still being crunched. The theory behind the device makes perfect sense, but surely nothing could be that simple...

Time will tell.
 
Epi-do said:
There is a ResQPod trial going on in Indy right now. Our service isn't part of it, but we still have to submit cardiac arrest info even though we don't have the random bags on our trucks.
Click to expand...

Err, you are very much a part of it and an important part at that. Every study needs a control.
 
JPINFV said:
Err, you are very much a part of it and an important part at that. Every study needs a control.
Click to expand...

Yes, you are correct about being a control for the study. Poor choice of words on my part. I just meant that we aren't getting the various bags with the rescupods in them.
 
Near as I can tell the studies that ResQpod proponents like to swing around have too many variables. They are either conducted on swine (equal amount that found no change with sham device) or are also done with "new CPR" or other things that likely contribute to the claimed improved outcomes.

Jeff
 
Last edited by a moderator:
"New CPR" is no longer new, its almost 4 years old. the ITD received a IIa rating from the AHA in 2005. It must be doing something right..................

I used it as part of the initial trial with Cypress Creek EMS. It made a dramatic improvement in our discharge rates. If you take a look at all of the "leaders in CPR survival", i.e. Wake County, King Medic 1, Cypress Creek, Rochester MN, etc. they all have something in common. Can you guess what it is??????????

It has been shown, regardless of scrutiny, that an ITD, along with effective CPR and hypothermia can increase survivability. There will always be factors outside of mankinds control, but using the resources we have now and in the future, we can increase the likelihood of survivability.
 
I agree that there are too many new variables with the ResQ pod trial. Not only did we add the Resq Pod and Pump, we also:
1. C-Collared and back boarded all codes
2. We worked all patients on scene for 30 minutes prior to transport
3. We also did a new CPR where the palm of the hand came entirely off of the chest on the "up" CPR movement.

It's hard to tell what, if anything, helped the patient with so many variables.
 
You must log in or register to reply here.
Back
Top