Introducing the New Way to Do CPR
by Rynae Golke
If you have ever had to perform CPR for more than thirty seconds, you know how incredibly exhausting and physically demanding it really is. Doing CPR on a human being is nothing like it is when you practice on a mannequin in class – not only is it more emotional and more mentally trying, but it takes far more physical effort than most healthcare professionals ever imagine.
The Impact of Ineffective CPR
Chest compressions are designed to restore circulation in patients suffering from cardiac arrest, pumping oxygen-rich blood to the brain and vital organs until further intervention can be administered.
According to the American Heart Association (AHA), when CPR is performed correctly, compressions should be delivered at a rate of 100 to 120 per minute, or up to two compressions per second. In addition, each compression should be 2 to 2.4 inches deep, according to the American Heart Association News. Combine the amount of physical effort required to perform CPR correctly – at up to 120 compressions per minute that are at least two inches deep – and it isn’t hard to see why traditional CPR has a low success rate.
According to a study published in JAMA, The Journal of the American Medical Association, the quality of CPR given by trained healthcare professionals falls short of AHA guidelines. As a matter of fact, the depth of chest compressions was less than two inches in 37.4% of total compressions delivered. When the study was performed, the recommended compression rate was 90 per minute, significantly less than today, and yet over 28% of 30-second segments failed to meet recommendations for compression rate.
The efficacy of CPR diminishes greatly when recommendations are not being met, and this study illustrates that even those who are trained and who perform CPR often struggle to keep up with the physical demand.
New Technology Changes CPR
Technology has come a long way to make life as convenient and enjoyable as possible; you can close your garage door or turn your oven off from your office in the city and use your thumbprint to get into your cell phone if you have the latest electronics on the market. Why not apply smart technology to lifesaving measures like CPR?
In response to the low efficacy of CPR and the low compliance rate of those performing it, two companies have developed and introduced an automated solution for chest compressions. Zoll has created AutoPulse and LUCAS CPR has developed the LUCAS Chest Compression System.
While each system appears and works a little differently, both provide the same results: CPR that does not vary with rescuer knowledge or skill level, that does not wane with a tiring rescuer, and that is not interrupted for transport, rescuer rotation, or other factors. These machines deliver chest compressions in accordance with the most recent scientific guidelines, ensuring that compressions are adequately deep and fast.
Both machines cost around $15,000, can accommodate a wide range of patients, and are being used in ambulances and emergency rooms across the United States. As a matter of fact, many healthcare facilities and transport vehicles have a policy in place that recommends the application of an automated CPR device to any patient at significant risk of arresting to avoid delay in initiating compressions.
Efficacy of Manual vs. Automated CPR
A study performed in 2011 and published in BMC Emergency Medicine explored the efficacy of manual chest compressions versus those delivered by an automated CPR device, specifically AutoPulse. Nearly 300 patients were studied and 11% more patients survived to hospital when compressions were done by a device instead of a rescuer.
How Does it Work?
The first question many healthcare professionals ask is, “How does it work?” Each system works differently to deliver effective compressions:
- The LUCAS Chest Compression System consists of a small backboard that is placed behind the patient, either by rolling the patient from side to side or simply lifting the patient’s upper body off the ground or other firm surface. The arch-shaped device snaps onto the sides of the backboard (under the patient’s arms), and sits several inches above the patient’s chest before initiated. Digital controls allow you to extend a large suction cup down to the patient’s chest and begin compressions. The machine will alert you if the patient is too small or too large.
- The AutoPulse consists of a larger backboard that extends from the waist to above the head for most patients. The backboard is position under the patient and the “LifeBand,” a softer, more flexible device, is attached just below the underarms. The LifeBand pulls itself down toward the backboard to deliver compressions.
Both devices are charged when not in use and can be unplugged and run on battery power during use for maximum portability.
The Healthcare Professional’s Role
If your organization is not using an automated CPR device yet, you may be able to help get this lifesaving equipment in the door. Healthcare professionals can help by making recommendations to senior management accompanied by reliable statistics and return on investment information. You can also help by looking for grants that may support the purchase; many small hospitals have access to automated CPR devices as the result of a grant.
What will we see next as technology continues to evolve and advance?