Abstract 38: North American LUCAS Evaluation: Prehospital Use of a Mechanical Chest Compression System
Background: Sudden cardiac death (SCD) is a major clinical and public health problem. Because cardiac arrest outcomes are improved by CPR, the 2005 AHA guidelines have placed renewed emphasis on the importance of CPR relative to other therapies provided during resuscitation. However, recent evidence has pointed out inadequacies of EMS manual chest compressions; pauses in chest compressions are frequent and prolonged and most manual compressions were too shallow. Several systems are now available to provide mechanical chest compressions. We evaluated the usability of one such system, the LUCAS™ Chest Compression System (LUCAS), used in four large US EMS systems to treat 317 victims of out-of-hospital cardiac arrest (OHCA).
Methods and Results: Sixty-six LUCAS devices were deployed in four large EMS systems, selected based on historical volume of OHCA calls, a proven ability to collect OHCA data, and our desire to gain experience in several different demographic regions of the US. Firefighters and paramedics were asked to apply and use the device to treat all OHCA victims they would normally treat with manual compressions. Exclusions included traumatic arrest, pregnancy and age < 18 years. Over six months, we collected usability and census information on 332 OHCA victims. LUCAS fit 317 of the 332 patients (95%) on whom its application was attempted. Prehospital providers' estimates of the pause in CPR for LUCAS application were less than 20 seconds in 71% of the cases. On scale of 1 to 10, providers rated ease of use of LUCAS an average of 9.0 ± 1.4 and perceived effectiveness of LUCAS to provide quality compressions on a scale of 0 to 10 an average of 9.3 ± 1.4 in the 317 patients.
Conclusions: This pilot data indicates that application of LUCAS by US prehospital providers is feasible and can be accomplished quickly, and that the device fits most patients. We recommend further study of the LUCAS device in the US to gain a better understanding of its effect on clinical resuscitation outcomes including ROSC and survival.
- © 2010 by American Heart Association, Inc.