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AutoPulse vs. LUCAS2 Mechanical CPR Devices

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Dana Potje

on 4 December 2013

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Transcript of AutoPulse vs. LUCAS2 Mechanical CPR Devices

Effectiveness of LUCAS2 vs. AutoPulse for CPR
Dana Potje, Alyson Fisher, Dave Rankin, Michele Titmarsh, Heather Struyk

Introduction
Approximately 40,000 Canadians suffer cardiac-related emergencies each year
Paramedics are the first responders to many of these events
Cardiopulmonary Resuscitation (CPR) is often necessary to treat patients who are in cardiac arrest

American Heart Association (AHA) Guidelines
2010 Guidelines suggest:
30 compressions to 2 ventilations
at least 100 compressions per minute
2 inch depth for adults
allow for complete chest recoil after each compression
avoid excessive ventilations
minimize interruptions in chest compressions (AHA, p. 1&2, 2010)

History of the LUCAS2
1991 - Willy Vistung created a working mechanical CPR device

2000 - Jolife took over to manufacture the device

2004 - Jolife signs agreement with Physio-Control for distribution globally



History of the AutoPulse
Originally created by Revivant Corporation

2003 - Revivant entered partnership with Zoll Medical Corporation to manufacture the AutoPulse

Education
EMS use of mechanical CPR devices is becoming widespread
Operation required: first aid skills and training for specific device
Benefit of mechanical CPR instruction
Things to be introduced:
Instruction within colleges
Instruction within first aid courses
Corporate Cost
Weight
The LUCAS 2 weighs roughly 22lbs in the pack with an extra battery
LUCAS2 Battery Life
Runs on a lithium polymer (LiPo) battery
Lighter than traditional nickel and metal batteries
4 hours for complete charge
Lasts for 45 minutes of operation

LUCAS2 Battery
Runs on a lithium polymer (LiPo) battery
Lighter than traditional nickel and metal batteries
4 hours for complete charge
Lasts for 45 minutes of operation

AutoPulse Battery
Lithium polymer battery
Can also run on the nickel metal hydride battery
Operational time of 30 minutes
6 hours to fully charge lithium polymer battery

Servicing
AutoPulse

Daily check by paramedic: rotate batteries and complete a self test

LUCAS2
Yearly servicing required
Representative comes to service and maintenance done on site

Pad Placement
LUCAS2
Pad Placement
AutoPulse
LUCAS2 Contraindications
Chest width >44.9cm (17.7')

Sternum height >30.3cm (11.9")

Must be paused when moving a patient at an angle
AutoPulse Contraindications
>300 pounds

Traumatic cardiac arrest patients

<18 years of age

At >45 degree angle the device must be paused
Coronary Perfusion Pressure
15mmHg coronary perfusion pressure (CPP) to achieve a return of spontaneous circulation

Manual CPR CPP 7mmHg

LUCAS2 CPP 22mmHg

AutoPulse's CPP 87mmHg
Both have >90% recoil of the heart

Allow for full decompression and perfusion
Recoil of the Heart
ROSC Rates
LUCAS2 has no increase in ROSC rates
than manual CPR

AutoPulse has a 10.3% increase in ROSC
rates than manual CPR
Compression Force
Piston-driven system operates 4.50 times above the reported threshold for safe chest compressions

Pressure delivered by the load
distributing band system is
50% lower than the reported
threshold for chest
compressions injuries
Manual Chest Compressions
Manual CPR interruptions are far greater than application time of a mechanical CPR device because:
10 seconds are lost to lift and move the patient to a firm surface
10 seconds are lost to place and secure the patient onto a transfer device
50 seconds are lost during rescuer compressor switches at a code, calculated based on this occuring (as recommended) every two minutes (estimated as 10 times during a ten minute resuscitation= 10x5 seconds)
20 seconds are lost while attempting to intubate the patient
180 seconds (minimum) are lost during extrication from second floor of a building
100 seconds (minimum) are lost during the removal of the patient, movement into the emergency department and transfer over to the hospitals gurney (Heightman, 2010)
Chest Compression Injury Mechanism
"Good CPR breaks ribs"
LUCAS2 chest compressions applies pressure to the sternum and has an increased risk of causing:
broken ribs
crushing certain organs if suction cup becomes displaced (liver, spleen)
AutoPulse distributes the force of compression across the load-distributing band
Lowers the risk of fractures or other injuries
Rescuers encouraged to draw a line around suction cup to notice when displacement occurs
To correct device must be paused and moved back to proper position
Avoiding Injury with the LUCAS2
Possible Injuries During a Motor Vehicle Collision
LUCAS2 caused injury to the mannequin’s head
Deformed the spine
LUCAS2 has no safety turn off mechanism if moved to a non-therapeutic position
AutoPulse did not cause damage to the mannequin
Agenda
Abstract and Introduction
Education and History
Demonstration
Specifics and Contraindications
Statistics
Conclusion
Acknowledgments
References
Questions
Questions?
Conclusion
Increased coronary perfusion pressure than manual CPR
Frees paramedics hands
Increased safety for paramedics
Secures patients arms during operation
Meets AHA Guidelines
Weighs and costs less
No safety turn off if an accident were to occur
No need to be paused when moving the patient <45 degrees
Torso is supported by built in back plate
LDB has less chance of chest injury
Does not meet AHA Guidelines
LUCAS2
AutoPulse
Acknowledgments
A special thank you goes out to the Superintendent of MLEMS, Jay Loosley and the Supervisor of EMS Professional Standards of Oxford County EMS, Stephen Turner
Also a big thanks to Zoll representative Joel Sherwood and the Physio-Control marketing manager Jay Mitchosky and territory manager Kenneth Stubbs for providing data
Final thanks to our professors Denise Blay and Gord Kinney
Load-Distributing Band versus Piston-Driven Systems. Zoll, 2, 2. Retrieved November 7, 2013 from: http://www.zoll.com/uploadedFiles/Public_Site/Products/AutoPulse/AutoPulse-Tech- Report2-chest-compression.pdf
Resuscitation Technology. (n.d.). Michigan Instruments |Thumper- Model 1007CCV. Retrieved November 22, 2013, from http://www.michiganinstruments.com/thumper-model-
Zoll Medical Corporation "AutoPulse Non-Invasive Cardiac Support Pump." - Automated CPR. Zoll Medical Corporation, n.d. Web. Nov. 2013.
Figure 1 : Google images search: http://www.physio- control.com/uploadedImages/products/cpr-assist-devices/product_data/LUCAS2_large.jpg Figure 2: Google Images search: http://www.zoll.com/uploadedImages/Public_Site/Products/Product_Data/Auto_Pulse.jpg Figure 3: Physio-Control Lucas® 2, Chest Compression System, Genuine Accessories from Physio-Control. Redmond, WA : Physio-Control, 2012. Print.
Figure 4: AutoPulse Non-invasive Cardiac Support Pump. (n.d.). ZOLL Medical Corporation. Zoll.com
Figure 5: AutoPulse Non-invasive Cardiac Support Pump. (n.d.). ZOLL Medical Corporation. Zoll.com
Figure 6: Physio-Control Lucas® 2, Chest Compression System, Genuine Accessories from Physio-Control. Redmond, WA : Physio-Control, 2012.
Figure 7 retrieved from google search: http://www.ff-oberschleissheim.de/cms/first- responder/ausruestung/qautopulseq.html
Figure 8 retrieved from google search:
http://www.medgadget.com/2007/10/lucas_chest_compression_system_offers_a_new_cpr_e xperience.html
Figure 9: Google image search: http://resusintl.com/wp-content/uploads/2011/03/front-w- strap.jpg
Figure 10: Resuscitation Technology. (n.d.). Michigan Instruments |Thumper- Model 1007CCV. Retrieved November 22, 2013, from http://www.michiganinstruments.com/thumper-model- 1007ccv\
Figure 11: Potential Chest Compression Injury Mechanism from Mechanical CPR Systems: Comparison of Load-Distributing Band versus Piston-Driven Systems. Zoll, 2, 2. Retrieved November 7, 2013 from: http://www.zoll.com/uploadedFiles/Public_Site/Products/AutoPulse/AutoPulse-Tech-Report2-chest- compression.pdf
Figure 12: Patient Injury Potential from Mechanical CPR Devices During Collision: Comparison of Load-Distributing Band Versus Piston-Driven Systems. Zoll, 3, 2. Retrieved November 7, 2013, from http://www.zoll.com/uploadedFiles/Public_Site/Products/AutoPulse/AutoPulse-Tech- Report1-Blood-Flow.pdf (2013).
American Heart Association Guidelines for CPR and ECC. 2010. Supplement to Circulation. Volume 122. Issue 18. Supplement 3. November 2. 2010.
AUTOMATED CPR. (n.d.). Automated CPR. Retrieved November 24, 2013, from http://www.resuscitationcentral.com/circulation/content.aspx?id=2250
AutoPulse Non-invasive Cardiac Support Pump. (n.d.). ZOLL Medical Corporation. Retrieved November 3, 2013, from http://www.zoll.com/uploadedFiles/Public_Site/Products/AutoPulse/AutoPulse_Brochure_040 9(1).pdf
Compression efficacy. (n.d.). Welcome to Lucas CPR • LUCAS CPR • LUCASTM clinical overview •. Retrieved November 23, 2013, from http://www.lucas- cpr.com/en/lucas_cpr/lucas_clinical_overview/compression_efficacy
Halperin HR et al. Journal of the American College of Cardiology. 2004; 44(11):2214-2220. Heightman, A.J. “The 2010 AHA CPR Guidelines Released”. JEMS November 2010. Retrieved
from: http://www.jems.com/article/patient-care/2010-aha-cpr-guidelines-releas Helping save lives... Worldwide.. (n.d.). Resus International. Retrieved November 23, 2013, from
http://resusintl.com
History. (n.d.). LUCAS Chest Compression System. Retrieved November 23, 2013, from
http://www.lucas-cpr.com/en/about_us/history
LUCAS 2 Chest Compression System. (n.d.). LUCAS Chest Compression System. Retrieved November 3, 2013, from http://www.lucas-cpr.com/doc_en/100666- 00_Rev_F_LUCAS2_IFU_US.pdf
LUCASTM2 SW 2.1. (n.d.). LUCAS Chest Compression System. Retrieved November 23, 2013, from
http://www.lucas- cpr.com/en/lucas_cpr/technical_info_and_instructions_for_use/lucas2_sw_21
Lundy D, McGeorge W, Silver A. Circulation. 2009;120:S1470-71
References
Loosley Jay, "Discussion of Lucas Device with Jay Loosley." Personal interview. 30 Nov. 2013.
Mal, S. (Director) (2011, November 26). Automated CPR and Defibrillation: The Future Of Cardiac Arrest Management. PGY3 Emergency Medicine. Lecture conducted from London Health Sciences Centre, London.
Mechanical CPR Summary of Comparative Human Findings. (2013). Canada: Zoll Medical Corporation.
Milestones in History. (n.d.). ZOLL Medical Corporation. Retrieved October 10, 2013, from http://http://www.zoll.com/about-zoll/corporate-milestones/ /thumper-model-1007ccv
MLEMS. CPR Report. Rep. no. 1. London: n.p., 2013. Print.
MLEMS. CPR Report. Rep. no. 2. London: n.p., 2013. Print.
MLEMS. CPR Report. Rep. no. 3. London: n.p., 2013. Print.
Olasveengen TM, Wik L, Steen PA. Resuscitation. 2008;76:185-90
Patient Injury Potential from Mechanical CPR Devices During Collision: Comparison of Load-
Distributing Band Versus Piston-Driven Systems. Zoll, 3, 2. Retrieved November 24, 2013, from http://www.zoll.com/uploadedFiles/Public_Site/Products/AutoPulse/AutoPulse-Tech- Report1-Blood-Flow.pdf (2013).
Physio-Control. Lucas 2 Chest Compression System, Quick Reference Card. Redmond, WA: Physio-Control, 2012. Print.
Physio-Control Why Choose LUCAS? Clinical Overview. Lund, Sweden: Jolife AB, 2013. Print.
Physio-Control Lucas® 2, Chest Compression System, Genuine Accessories from Physio-Control. Redmond, WA : Physio-Control, 2012. Print.
Potential Blood Flow from Mechanical CPR Technologies: Comparison of Load-
Distributing Band Versus Piston-Driven Systems. Zoll, 1, 1. Retrieved November 24, 2013, from http://www.zoll.com/uploadedFiles/Public_Site/Products/AutoPulse/AutoPulse-Tech- Report1-Blood-Flow.pdf
Potential Chest Compression Injury Mechanism from Mechanical CPR Systems: Comparison of
References
References
Benefits of Mechanical CPR
Safer for paramedics

Allows for consistent compressions

Fewer responders required on the call

Frees paramedics hands
Full transcript