Mechanical chest compression: an alternative in helicopter emergency medical services?
- 329 Downloads
Mechanical chest compression devices are mentioned in the current guidelines of the European Resuscitation Council (ERC) as an alternative in long-lasting cardiopulmonary resuscitations (CPR) or during transport with ongoing CPR. We compared manual chest compression with mechanical devices in a rescue-helicopter-based scenario using a resuscitation manikin. Manual chest compression was compared with the mechanical devices LUCAS™ 2, AutoPulse™ and animax mono (10 series each) using the resuscitation manikin AmbuMan MegaCode Wireless, which was intubated endotracheally and controlled ventilated during the entire scenario. The scenario comprised the installation of each device, transport and loading phases, as well as a 10-min phase inside the helicopter (type BK 117). We investigated practicability as well as measured compression quality. All mechanical devices could be used readily in a BK 117 helicopter. The LUCAS 2 group was the only one that fulfilled all recommendations of the ERC (frequency 102 ± 0.1 min−1, compression depth 54 ± 3 mm, hands-off time 2.5 ± 1.6 %). Performing adequate manual chest compression was barely possible (fraction of correct compressions 21 ± 15 %). In all four groups, the total hands-off time was <10 %. Performing manual chest compressions during rescue-helicopter transport is barely possible, and only of poor quality. If rescuers are experienced, mechanical chest compression devices could be good alternatives in this situation. We found that the LUCAS 2 system complied with all recommendations of ERC guidelines, and all three tested devices worked consistently during the entire scenario.
KeywordsResuscitation Transport Mechanical chest compression devices Manikin Helicopter emergency medical services
- 3.Soar J, Perkins GD, Abbas G, Alfonzo A, Barelli A, Bierens JJLM, Brugger H, Deakin CD, Dunning J, Georgiou M, Handley AJ, Lockey DJ, Paal P, Sandroni C, Thies KC, Zideman DA, Nolan JP (2010) European Resuscitation Council Guidelines for Resuscitation 2010. Section 8. Cardiac arrest in special circumstances: electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma, anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution. Resuscitation 81:1400–1433CrossRefPubMedGoogle Scholar
- 10.Fischer M, Ihli M, Messelken M (2010) Mechani-sche Reanimationsgeräte. Notfall + Rettungsmedizin 13:189–196Google Scholar
- 15.Ong ME, Quah JL, Annathurai A, Noor NM, Koh ZX, Tan KB, Pothiawala S, Poh AH, Loy CK, Fook-Chong S (2013) Improving the quality of cardiopulmonary resuscitation by training dedicated cardiac arrest teams incorporating a mechanical load-distributing device at the emergency department. Resuscitation 84:508–514CrossRefPubMedGoogle Scholar
- 16.Yost D, Phillips RH, Gonzales L, Lick CJ, Satterlee P, Levy M, Barger J, Dodson P, Poggi S, Wojcik K, Niskanen RA, Chapman FW (2012) Assessment of CPR interruptions from transthoracic impedance during use of the LUCAS™ mechanical chest compression system. Resuscitation 83:961–965CrossRefPubMedGoogle Scholar
- 17.Meaney PA, Bobrow BJ, Mancini ME, Christenson J, de Caen AR, Bhanji F, Abella BS, Kleinman ME, Edelson DP, Berg RA, Aufderheide TP, Menon V, Leary M, on behalf of the CPR Quality Summit Investigators, the American Heart Association Emergency Cardiovascular Care Committee, and the Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation (2013) CPR quality: improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation 128:417–435CrossRefPubMedGoogle Scholar
- 21.Curtis VJ (2007) The Three Block War: its causes and the shape of the peace. Can Army J 10(2):49–65Google Scholar
- 22.Weller N (2010) Ausbildung im Sanitätsdienst der Bundeswehr – ein ständiger Lernprozess. Wehrmedizin Wehrpharmazie 4:16–19Google Scholar
- 23.Helm M, Lührs J, Josse F, Kremers G, Weller N, Lampl L (2012) Konzept zur Basisausbildung von Notärzten im Sanitätsdienst der Bundeswehr. Ein Pilotprojekt am Bundeswehrkrankenhaus Ulm. Notfall + Rettungsmedizin 15(2):146–151Google Scholar