Skip to main content
SpringerLink
Log in

Mechanische Thoraxkompressionsgeräte in der Luftrettung

Indikationen bei Windenrettung und Transport

Mechanical chest compression devices in air rescue services

Indications during hoist rescue and transportation

  • Übersichten
  • Published:
Notfall + Rettungsmedizin Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Die Evidenzlage unterstützt den prähospitalen Einsatz von mechanischen Thoraxkompressionsgeräten nicht. Dennoch gibt es Patienten, bei denen der prähospitale Einsatz solcher Geräte indiziert ist.

Methode

Anhand der vorliegenden Literatur soll die Indikation für den prähospitalen Einsatz von mechanischen Thoraxkompressionsgeräten unter besonderer Berücksichtigung der Bedürfnisse der Luftrettung dargestellt und diskutiert werden.

Ergebnisse

Es konnten drei Einsatzszenarien identifiziert werden, in denen der Einsatz von mechanischen Thoraxkompressionsgeräten in der Luftrettung indiziert ist. Dies sind Reanimationen im alpinen Gelände, Reanimationen bei akzidenteller Hypothermie und nach Lawinenunfall sowie der luftgestützte Transport von reanimationspflichtigen oder hochgradig instabilen Patienten. Diese Indikationen werden unter Berücksichtigung der aktuellen Literatur diskutiert. Vor- und Nachteile der beiden am Markt befindlichen Thoraxkompressionsgeräte (LUCAS und Autopulse) werden im Hinblick auf die Luftrettung dargestellt.

Abstract

Background

Evidence does not support the prehospital use of mechanical chest compression devices. Nevertheless, in certain patients their use might be indicated.

Methods

Therefore, on the basis of the existing literature indications for the prehospital use of mechanical chest compression devices are presented and discussed with particular focus on air rescue service.

Results

Three scenarios where the use of mechanical chest compression devices is indicated could be identified. These are cardiopulmonary resuscitation in the alpine terrain, resuscitation of patients with accidental hypothermia and of avalanche victims, and resuscitation during airborne transport. Advantages and disadvantages of the two chest compression devices on the market (LUCAS and Autopulse) are discussed with regard to air rescue service.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3

Literatur

  1. Wik L, Olsen JA, Persse D, Sterz F, Lozano M Jr., Brouwer MA, Westfall M, Souders CM, Malzer R, van Grunsven PM, Travis DT, Whitehead A, Herken UR, Lerner EB (2014) Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial. Resuscitation 85:741–748

    Article  PubMed  Google Scholar 

  2. Perkins GD, Quinn T, Deakin CD, Lall R, Gates S (2015) Mechanical chest compression in the PARAMEDIC trial – authors’ reply. Lancet 386:26–27

    Article  PubMed  Google Scholar 

  3. Rubertsson S, Lindgren E, Smekal D, Ostlund O, Silfverstolpe J, Lichtveld RA, Boomars R, Ahlstedt B, Skoog G, Kastberg R, Halliwell D, Box M, Herlitz J, Karlsten R (2014) Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial. JAMA 311:53–61

    Article  CAS  PubMed  Google Scholar 

  4. Luxen JB, Birkholz T, Hatz A, Kanz KG, Königer J, Meier M, Urban B, Trentzsch H (2015) Nutzen mechanischer Reanimationshilfen bei der kardiopulmonalen Reanimation. Notfall Rettungsmed 18:119–129

    Article  Google Scholar 

  5. Soar J, Nolan JP, Bottiger BW, Perkins GD, Lott C, Carli P, Pellis T, Sandroni C, Skrifvars MB, Smith GB, Sunde K, Deakin CD, Adult advanced life support section C (2015) European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation 95:100–147

    Article  PubMed  Google Scholar 

  6. Youngquist ST, Ockerse P, Hartsell S, Stratford C, Taillac P (2016) Mechanical chest compression devices are associated with poor neurological survival in a statewide registry: A propensity score analysis. Resuscitation 106:102–107

    Article  PubMed  Google Scholar 

  7. Bernhard M, Hossfeld B, Kumle B, Becker TK, Bottiger B, Birkholz T (2016) Don’t forget to ventilate during cardiopulmonary resuscitation with mechanical chest compression devices. Eur J Anaesthesiol 33:553–556

    Article  PubMed  Google Scholar 

  8. Hilmo J, Naesheim T, Gilbert M (2014) „Nobody is dead until warm and dead“: prolonged resuscitation is warranted in arrested hypothermic victims also in remote areas–a retrospective study from northern Norway. Resuscitation 85:1204–1211

    Article  PubMed  Google Scholar 

  9. Bottiger BW, Grabner C, Bauer H, Bode C, Weber T, Motsch J, Martin E (1999) Long term outcome after out-of-hospital cardiac arrest with physician staffed emergency medical services: the Utstein style applied to a midsized urban/suburban area. Heart 82:674–679

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Truhlar A, Deakin CD, Soar J, Khalifa GE, Alfonzo A, Bierens JJ, Brattebo G, Brugger H, Dunning J, Hunyadi-Anticevic S, Koster RW, Lockey DJ, Lott C, Paal P, Perkins GD, Sandroni C, Thies KC, Zideman DA, Nolan JP, Cardiac arrest in special circumstances section C (2015) European Resuscitation Council Guidelines for Resuscitation 2015: Section 4. Cardiac arrest in special circumstances. Resuscitation 95:148–201

    Article  PubMed  Google Scholar 

  11. Brown DJ, Brugger H, Boyd J, Paal P (2012) Accidental hypothermia. N Engl J Med 367:1930–1938

    Article  CAS  PubMed  Google Scholar 

  12. Schneider SM (1992) Hypothermia: from recognition to rewarming. Emerg Med Rep 13:1–20

    Google Scholar 

  13. McCormack J, Percival D (2016) HEMS advanced trauma team retrieval of a patient with accidental hypothermic cardiac arrest for ECMO therapy. Resuscitation 105:e23

    Article  PubMed  Google Scholar 

  14. Brugger H, Putzer G, Paal P (2013) Accidental hypothermia. Anaesthesist 62:624–631

    Article  CAS  PubMed  Google Scholar 

  15. Brugger H, Durrer B, Elsensohn F, Paal P, Strapazzon G, Winterberger E, Zafren K, Boyd J, Icar M (2013) Resuscitation of avalanche victims: Evidence-based guidelines of the international commission for mountain emergency medicine (ICAR MEDCOM): intended for physicians and other advanced life support personnel. Resuscitation 84:539–546

    Article  PubMed  Google Scholar 

  16. Wanscher M, Agersnap L, Ravn J, Yndgaard S, Nielsen JF, Danielsen ER, Hassager C, Romner B, Thomsen C, Barnung S, Lorentzen AG, Hogenhaven H, Davis M, Moller JE (2012) Outcome of accidental hypothermia with or without circulatory arrest: experience from the Danish Praesto Fjord boating accident. Resuscitation 83:1078–1084

    Article  PubMed  Google Scholar 

  17. Ruttmann E, Weissenbacher A, Ulmer H, Muller L, Hofer D, Kilo J, Rabl W, Schwarz B, Laufer G, Antretter H, Mair P (2007) Prolonged extracorporeal membrane oxygenation-assisted support provides improved survival in hypothermic patients with cardiocirculatory arrest. J Thorac Cardiovasc Surg 134:594–600

    Article  PubMed  Google Scholar 

  18. Stub D, Bernard S, Pellegrino V, Smith K, Walker T, Sheldrake J, Hockings L, Shaw J, Duffy SJ, Burrell A, Cameron P, de Smit V, Kaye DM (2015) Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation 86:88–94

    Article  PubMed  Google Scholar 

  19. Stub D, Nehme Z, Bernard S, Lijovic M, Kaye DM, Smith K (2014) Exploring which patients without return of spontaneous circulation following ventricular fibrillation out-of-hospital cardiac arrest should be transported to hospital? Resuscitation 85:326–331

    Article  PubMed  Google Scholar 

  20. Drennan IR, Lin S, Sidalak DE, Morrison LJ (2014) Survival rates in out-of-hospital cardiac arrest patients transported without prehospital return of spontaneous circulation: an observational cohort study. Resuscitation 85:1488–1493

    Article  PubMed  Google Scholar 

  21. Rittenberger JC, Hostler DP, Tobin T, Gaines J, Callaway CW (2008) Predictors of ROSC in witnessed aeromedical cardiac arrests. Resuscitation 76:43–46

    Article  PubMed  Google Scholar 

  22. Stapleton ER (1991) Comparing CPR during ambulance transport. Manual vs. mechanical methods. JEMS 16:63–64 (66, 68)

    CAS  PubMed  Google Scholar 

  23. Putzer G, Braun P, Zimmermann A, Pedross F, Strapazzon G, Brugger H, Paal P (2013) LUCAS compared to manual cardiopulmonary resuscitation is more effective during helicopter rescue – a prospective, randomized, cross-over manikin study. Am J Emerg Med 31:384–389

    Article  PubMed  Google Scholar 

  24. Thomas SH, Stone CK, Bryan-Berge D (1994) The ability to perform closed chest compressions in helicopters. Am J Emerg Med 12:296–298

    Article  CAS  PubMed  Google Scholar 

  25. Frey M, Lotscher S, Theiler L, Albrecht R (2016) Arterial blood pressure differences between AutoPulse and Lucas2during mechanic cardiopulmonary resuscitation. Scand J Trauma Resusc Emerg Med 24:64

    Article  PubMed  PubMed Central  Google Scholar 

  26. Rehatschek G, Muench M, Schenk I, Dittrich W, Schewe JC, Dirk C, Hering R (2016) Mechanical LUCAS resuscitation is effective, reduces physical workload and improves mental performance of helicopter teams. Minerva Anestesiol 82:429–437

    PubMed  Google Scholar 

  27. Wirth S, Korner M, Treitl M, Linsenmaier U, Leidel BA, Jaschkowitz T, Reiser MF, Kanz KG (2009) Computed tomography during cardiopulmonary resuscitation using automated chest compression devices – an initial study. Eur Radiol 19:1857–1866

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik für Anästhesiologie, Intensiv-, Rettungs- und Schmerzmedizin, Kantonsspital St. Gallen, St. Gallen, Schweiz

    U. Pietsch

  2. Abteilung für Anästhesie und operative Intensivmedizin, Hochtaunus-Kliniken gGmbH Krankenhaus Bad Homburg, Bad Homburg, Deutschland

    V. Lischke

  3. Air Zermatt, Zermatt, Schweiz

    U. Pietsch, V. Lischke &  J. Knapp DESA, EDIC

  4. Klinik für Anästhesiologie und Schmerztherapie, Universitätsspital Bern, Universität Bern, 3010, Bern, Schweiz

    J. Knapp DESA, EDIC

Authors
  1. U. Pietsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Lischke
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Knapp DESA, EDIC
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Knapp DESA, EDIC.

Ethics declarations

Interessenkonflikt

U. Pietsch, V. Lischke und J. Knapp geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pietsch, U., Lischke, V. & Knapp, J. Mechanische Thoraxkompressionsgeräte in der Luftrettung. Notfall Rettungsmed 20, 396–402 (2017). https://doi.org/10.1007/s10049-016-0262-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10049-016-0262-6

Schlüsselwörter

Keywords

Search

Navigation