New technology revolutionizes CPR on Cape Cod
Effective manual cardio pulmonary resuscitation (CPR) that is provided immediately after sudden cardiac arrest, can double or even triple a victim’s survival rate. Yet, more than 90 percent of victims still die before reaching the hospital, according to the American Heart Association.
That is why emergency medical services in several Cape Cod communities are adopting a new technology that literally takes CPR out of their hands. Hyannis, Falmouth and Dennis are among the departments that have already purchased $15,000 mechanical compression units called the LUCAS 2 as a complement to or substitute for manual CPR. Other communities are exploring ways to finance the equipment from taxes, grants and philanthropy.
As many as eight of every 10 sudden cardiac arrests not occurring in the hospital will happen at home. That creates a particular challenge on Cape Cod where many towns are 30 minutes or more from either Cape Cod Healthcare hospital in Hyannis and Falmouth.
It also makes effective CPR the difference between life and death.
John Adelizzi, EMS coordinator in the Dennis Fire Department, recently demonstrated LUCAS 2 to a meeting of local business people. A life-size dummy was on its back with the battery-powered device providing automated chest compression at a rate of 100 per minute and to a depth of about two inches, as prescribed by the American Heart Association.
“As effective as our EMTs are, manual CPR, especially over 30 minutes or longer, cannot replicate the consistency and stamina of a mechanical compressor,” Adelizzi explained. “It’s not only the time issue, but also the many degrees of difficulty associated with tending a patient, including the tight quarters and bumpy ride of an ambulance.”
Often, EMTs must handle multiple life-saving tasks at the same time, or they have to maneuver victims through tight places that may interrupt the compressions. In particularly traumatic circumstances, like a recent shooting in Bourne, EMTs have to simultaneously address a gunshot wound and ventilate the victim while also performing CPR – all while the violent incident plays out.
Underscoring all this are AHA guidelines for CPR that stress the need for a consistent rate and depth of chest compressions.
“That’s why this new technology is so promising,” Adelizzi said.
“With manual CPR, many factors come into play, including fatigue, physical abilities, focus on several simultaneous tasks, poor-quality CPR during transportation on a stretcher and in the back of a transport vehicle, interruptions during movement of patient and variations in technique and training,” writes the Journal of Emergency Medical Services.
“In one study, it was demonstrated that manual CPR resulted in a rate of less than 80 compressions per minute 37 percent of the time,” it continued. Other studies looked at the challenge of performing correct CPR in various settings. They found that CPR was performed correctly only 54 percent to 78 percent of the time when a victim was on the floor; 46 percent in the back of a moving ambulance and 21 percent while being transported on a stretcher.
Like all technology, support for mechanical compressors like the LUCAS 2 (there are numerous technologies on the market), is by no means unanimous. Some critics point out that mechanical compressors have been available for many years, although today’s technology appears far superior. In one study reported in the Journal of the American Medical Association (JAMA), researchers concluded that among adults with out-of-hospital cardiac arrest “there was no significant difference between patients treated with the mechanical CPR algorithm or those treated with guideline-adherent manual CPR.”
For many local emergency service professionals, the experience with mechanical compressors like LUCAS 2 is proving positive, says Mark Dellner, chief of the Dennis Fire Department. “We’re seeing it work on the ground. It’s a new tool that makes a difference.”