The $16,000 machine can be a lifesaver. According to Rene, “It does CPR compression at the correct rate and distance. While the machine is operating, the EMTs are free to administer oxygen and start IV lines for meds. The best part is that the machine never gets tired.
“Another big benefit is that the machine can do compressions when we are moving down narrow stairs and carrying the patient to the ambulance. This machine, along with a defibrillator and the meds we carry, give the patient the best chance for a positive outcome.” Photo: John Bridgmon
911 emergency medical calls are made for many reasons. Our volunteer emergency medical technicians (EMTs) never really know when or for what reason their pagers may be activated. Of all the reasons, few can match the urgency for a sudden cardiac arrest – when the heart unexpectedly stops pumping and thus blood circulation stops. A clear majority of cardiac arrests are caused by specific cardiac conditions, however a wide range of other events can cause a cardiac arrest, for example: drowning, asthma, anaphylactic shock or traffic accidents. With a sudden cardiac arrest, the patient quickly becomes unconscious, without any subsequent breathing or pulse. Sudden cardiac arrest remains a leading cause of death and can strike even the young and athletic. Sadly, 95% of all sudden cardiac arrest patients die before they reach the hospital. Unfortunately these figures have not changed throughout the years. If advanced care is readily available, maybe as high as 25-30% of all patients could survive.
Sudden cardiac arrest can be reversible if the patient receives immediate care and the cause of the arrest can be found and treated appropriately. Ideally, with a witnessed cardiac arrest, a 911 call for help is made and chest compressions are started immediately to sustain blood flow to the patient’s brain. If needed, an early shock from an automated external defibrillator (AED) can potentially restart the heart’s pumping function. These actions together with advanced cardiopulmonary resuscitation (CPR) provided by swift-acting EMTs and followed by attentive hospital care are an integral part of the rescue activities that are called the chain of survival.
CPR Quality Matters
Many studies show that the quality of CPR prior to defibrillation directly affects clinical outcomes. Inconsistent and/or shallow chest compressions are strongly associated with defibrillation failure. This is most often the result of less-than-optimal positioning between patient and rescuer during transport as well as rescuer fatigue. Every interruption in chest compressions causes the coronary perfusion pressure to drop – a pressure that is correlated to successful restoration of heart rhythm. The longer the pre-shock pause is, the lower the success of the defibrillation.
Effective chest compressions deliver vital oxygen to the brain and can prime the heart for a successful shock. Maintaining sufficient coronary perfusion pressure during cardiac arrest improves the likelihood of return of spontaneous circulation (ROSC). However, as any rescuer or caregiver knows, performing manual CPR in the field according to current guidelines can be difficult and tiring. To make matters worse, Andover’s distance from Concord and Dartmouth hospitals, where cardiac arrest patients are likely to be transported, can result in a doubling of travel time.
A New Tool
The LUCAS Chest Compression System is designed to deliver uninterrupted compressions at a consistent rate and depth to facilitate ROSC. It delivers automated compressions from first response in the field, through ambulance transport, and throughout initial hospital care. LUCAS facilitates consistent blood flow from the moment it is turned on, helping to improve a patient’s chance for a successful outcome.
Several studies show the effectiveness of manual chest compressions can drop rapidly, often after only one minute, due to difficult positioning and rescuer fatigue. A study from New Orleans Emergency Medical Services presented at the American Heart Association (AHA) in mid November 2012 showed that the implementation of a new resuscitation protocol that included the use of the LUCAS Chest Compression System contributed to a 71% increase in the short term outcomes of cardiac arrest. The short term outcome was defined as a stable return of spontaneous circulation and went from 21% in the historical control group to 36% with the new treatment protocol.
Fundraising
For the first time in four years, since being elected as President of Andover Rescue Squad and subsequently appointed as EMS Chief for the Andover EMS Department, I respectfully make this plea for fundraising. Since seeing the LUCAS Chest Compression System and having reviewed the studies available, I feel this device will be a tremendous asset to our community.
Let’s not fool ourselves – this is not a magic device. If a cardiac arrest is unwitnessed and too much time passes before bystander CPR is initiated and is subsequently replaced with advanced CPR, the patient outcome is not likely to be changed.
However, for the times when events do fall into place and if a LUCAS device were available, I think we would all greatly welcome an improved chance for a positive outcome. Additional benefits for the use of a LUCAS device include freeing EMTs for other needed duties and tasks during a cardiac emergency, as well as allowing them to be more secure in the ambulance during an extended rapid transport rather than standing in a moving vehicle while trying to maintain quality CPR.
As with nearly all advanced medical aids, the LUCAS device is not inexpensive. Rather than use tax dollars for a non-mandated tool, we have opted to raise funds and seek out possible grant funding for the specific goal of adding a LUCAS Chest Compression System to the Andover EMS ambulance and to provide our EMT crew members with the training needed to make the most of this remarkable device.
During the Fourth of July celebration, please stop by the Andover Fire Department tent near the reviewing stand to see the LUCAS device for yourselves and to hear our personal stories/experiences about where we feel the LUCAS could have made a positive difference. We’ll also have on hand a new cardiac monitor, the LifePak-15, that is needed to replace our out-dated LifePak-12 – a significant piece of equipment in our arsenal for which we will no longer be able to purchase an annual service agreement after 2013.
Tax-deductible donations for either tool may be made payable to Andover EMS with “LUCAS” and/or “LifePak” in the memo field and will be collected on the Fourth of July or can be mailed to Andover EMS, PO Box 61, Andover 03216.