Internal and Emergency Medicine

, Volume 10, Issue 6, pp 715–720 | Cite as

Mechanical chest compression: an alternative in helicopter emergency medical services?

  • Holger GässlerEmail author
  • Simone Kümmerle
  • Marc-Michael Ventzke
  • Lorenz Lampl
  • Matthias Helm


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.


Resuscitation Transport Mechanical chest compression devices Manikin Helicopter emergency medical services 



This study is part of a dissertation thesis by Mrs. Simone Kümmerle.

Conflict of interest


Ethical standard

This article does not contain any studies with human participants performed by any of the authors.


  1. 1.
    Gräsner JT, Seewald S, Bohn A, Fischer M, Messelken M, Jantzen T, Wnent J (2014) Deutsches Reanimationsregister. Wissenschaft und Reanimationsforschung. Anaesthesist 63:470–476CrossRefPubMedGoogle Scholar
  2. 2.
    Deakin CD, Nolan JP, Soar J, Sunde K, Koster RW, Smith GB, Perkins GD (2010) European Resuscitation Council Guidelines for Resuscitation 2010. Section 4. Adult advanced life support. Resuscitation 81:1305–1352CrossRefPubMedGoogle Scholar
  3. 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
  4. 4.
    Sunde K, Wik L, Steen PA (1997) Quality of mechanical, manual standard and active compression-decompression CPR on the arrest site and during transport in a manikin model. Resuscitation 34:235–242CrossRefPubMedGoogle Scholar
  5. 5.
    Olasveengen TM, Wik L, Steen PA (2008) Quality of cardiopulmonary resuscitation before and during transport in out-of-hospital cardiac arrest. Resuscitation 76:185–190CrossRefPubMedGoogle Scholar
  6. 6.
    Ventzke MM, Gässler H, Lampl L, Helm M (2013) Cardio pump reloaded: in-hospital resuscitation during transport. Intern Emerg Med 8(7):621–626CrossRefPubMedGoogle Scholar
  7. 7.
    Gässler H, Ventzke MM, Lampl L, Helm M (2013) Transport with ongoing resuscitation. Emerg Med J 30:589–592CrossRefPubMedGoogle Scholar
  8. 8.
    Fox J, Fiechter R, Gerstl P, Url A, Wagner H, Lüscher TF, Eriksson U, Wyss CA (2013) Mechanical versus manual chest compression CPR under ground ambulance transport conditions. Acute Cardiac Care 15:1–6. doi: 10.3109/17482941.2012.735675 CrossRefPubMedGoogle Scholar
  9. 9.
    Fischer M, Brell M, Ihli M, Messelken M, Rauch S, Schewe JC (2014) Mechanische Reanimationshilfen. Anaesthesist 63:186–197CrossRefPubMedGoogle Scholar
  10. 10.
    Fischer M, Ihli M, Messelken M (2010) Mechani-sche Reanimationsgeräte. Notfall + Rettungsmedizin 13:189–196Google Scholar
  11. 11.
    Omori K, Sato S, Sumi Y, Inoue Y, Okamoto K, Uzura M, Tanaka H (2013) The analysis of efficacy for AutoPulse™ system in flying helicopter. Resuscitation 84:1045–1050CrossRefPubMedGoogle Scholar
  12. 12.
    Kyrval HS, Ahmad K (2010) Automatic mechanical chest compression during helicopter transportation. Ugeskr Laeger 172(46):3190–3191PubMedGoogle Scholar
  13. 13.
    Pietsch U, Lischke V, Pietsch C (2014) Benefit of mechanical chest compression devices in mountain HEMS: lessons learned from 1 year of experience and evaluation. Air Med J 33(6):299–301CrossRefPubMedGoogle Scholar
  14. 14.
    Ashton A, McCluskey A, Gwinnutt CL, Keenan AM (2002) Effect of rescuer fatigue on performance of continuous external chest compression over 3 minutes. Resuscitation 55(2):151–155CrossRefPubMedGoogle Scholar
  15. 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. 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. 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
  18. 18.
    Ong ME, Mackey KE, Zhang ZC, Tanaka H, Ma MH, Swor R, Shin SD (2012) Mechanical CPR devices compared to manual CPR during out-of-hospital cardiac arrest and ambulance transport: a systematic review. Scand J Trauma Resusc Emerg Med 20:39PubMedCentralCrossRefPubMedGoogle Scholar
  19. 19.
    Smekal D, Johansson J, Huzevka T, Rubertsson S (2009) No difference in autopsy detected injuries in cardiac arrest patients treated with manual chest compressions compared with mechanical compressions with the LUCASTM device—a pilot study. Resuscitation 80:1104–1107CrossRefPubMedGoogle Scholar
  20. 20.
    Willy C, Völker HU, Steinmann R, Engelhardt M (2008) Kriegschirurgische Verletzungsmuster. Update 2007. Der Chirurg 79:66–76CrossRefGoogle Scholar
  21. 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. 22.
    Weller N (2010) Ausbildung im Sanitätsdienst der Bundeswehr – ein ständiger Lernprozess. Wehrmedizin Wehrpharmazie 4:16–19Google Scholar
  23. 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
  24. 24.
    Dawes R (2009) Rhys Thomas GO. Battlefield resuscitation. Curr Opin Crit Care 15:527–535CrossRefPubMedGoogle Scholar

Copyright information

© SIMI 2015

Authors and Affiliations

  • Holger Gässler
    • 1
    Email author
  • Simone Kümmerle
    • 1
  • Marc-Michael Ventzke
    • 1
  • Lorenz Lampl
    • 1
  • Matthias Helm
    • 1
  1. 1.Section Emergency Medicine, Department of Anaesthesiology and Intensive Care MedicineArmed Forces Medical Centre UlmUlmGermany

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