Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Introduction: High quality CPR is critical for successful cardiac arrest outcomes. Mechanical devices may improve CPR quality. We simulated a prehospital cardiac arrest, including patient transport, and compared the performance of the LUCAS Chest Compression System to manual CPR. We hypothesized that because of the movement involved in transporting the patient, LUCAS would provide chest compressions more consistent with high quality CPR guidelines.

Methods: We performed a crossover controlled study in which a recording mannequin was placed on the second floor of a building. An EMS crew responded, defibrillated, and provided either manual or LUCAS CPR. The team transported the mannequin through hallways and down stairs to an ambulance and drove to the hospital with CPR in progress. Critical events were manually timed while the mannequin recorded data on compressions.

Results: Twenty-three EMS providers participated. Median time to defibrillation was not different for LUCAS compared to manual CPR (p=0.97). LUCAS had a lower median number of compressions per minute (p<0.002), which was more consistent with current American Heart Association CPR guidelines, and percent adequate compression rate (p<0.002). In addition, LUCAS had a higher percent adequate depth (p<0.007) lower percent total hands off time (p<0.005). LUCAS performed no differently than manual CPR in median compression release depth, percent fully released compressions, median time hands off, or percent correct hand position.

Conclusion: In our simulation, LUCAS had a higher rate of adequate compressions and decreased total hands off time as compared to manual CPR. Chest compression quality may be better when using a mechanical device during patient movement in prehospital cardiac arrest patients.