ResQPumps and ResQPods-what are your thoughts?

[BlackSheep]

For a clinical trial, paramedics in St. Paul and Minneapolis will be testing experimental suction devices on heart attack patients without their prior consent.

While informed consent is a staple of most medical research, exceptions are allowed when the consent impedes potentially lifesaving research that can't be completed any other way.

Hospital and emergency medicine leaders believe the devices will increase the number of survivors of heart attacks.

The tests will begin in September in St. Paul, Minneapolis and three other cities across the country.

"The survival rate from cardiac arrest has remained stagnant for the last 40 years," said Dr. Keith Lurie, a professor of medicine at the University of Minnesota who co-invented the device. Lurie formed Advanced Circulatory Systems Inc., an Eden Prairie company that now makes the two devices that will be tested in the study.

One is the ResQPump, which works somewhat like a household plunger and increases blood flow by manipulating the chest cavity.

The other is the ResQPod, which fits atop the device that paramedics place over a patients mouth during CPR. The pod expedites the flow of blood into the lungs by regulating how oxygen is exhaled and inhaled during resuscitation.

St. Paul paramedics were testing an early version of the ResQPump in 1992. But the trial was stopped when federal officials discovered that paramedics were testing the devices without gaining informed consent.

The St. Paul case inspired new regulations in 1996 that allowed waivers of consent in crisis scenarios.

The FDA only allows waivers when the research involves life-threatening health problems that lack satisfactory treatment options. The risks of the experimental device or procedure also must be comparable to the risks of existing therapies. And researchers who choose this method must notify the public before the study begins.

The premature halt to the older study in St. Paul was frustrating because paramedics and emergency room doctors believed the device was keeping patients alive, said Dr. R.J. Franscone, medical director of emergency medical services at Regions Hospital in St. Paul.

The pumping device since has been used in Europe, and research has shown that it doubles the blood flow in patients. When used in combination with the pod, the devices have quadrupled blood flow, Lurie said.

That is critical, he explained, because traditional cardiopulmonary resuscitation, or CPR, only generates 10 percent to 20 percent of the normal blood flow, and severe brain damage may result.

However, a California study published in 1995 found no difference between the use of the pump device and standard CPR, but that study didn't look at the additional use of the pod device. Lurie questioned the training provided to medics in that study.

The study will start in September and involve heart attack victims in St. Paul, Minneapolis and three other cities across the country.

[Ridryder 911]

OMG their trying to "revive " the old plunger again... Most of you do not the "rest of the story:.. a man had a cardiac arrest, his brother grabbed the toilet plunger & uses it to do chest compressions.. he was resuscitated & then he patented it..... tried to market it ...push it.. it was popular for about a year or so... in the early 80's....

This was about the time Amway had a answer to choking victims..a suction device to remove foreign bodies. A device that "suctioned or pulled the object out... unfortunately, whomever designed it forgot that the esophagus collapses under suction & actually squeezed the object tighter.. McDonald's had bought thousands for every restaurant...they got burned really bad after a law suit. So remember there are a lot of toys out there, be sure they are safe.

Be safe,

Ridryder 911

[Richard B the EMT]

I thought the "plunger" was from the early 1990s, but we could both be wrong.

[Ironvic]

There was a plunger used in the early 1970s that was pneumatic, I believe. The patirent was placed on the short backboard that was part of the unit and it used a sternum plunger to do compressions. I believe the attendant still had to ventilate with the demand valve (MTV, Elder valve etc.)

Our county is (Whatcom County, WA) also part of the Res-Q Pod study. It is a lot of work working that plunger, but it works well on the mannikin. We'll see how it does on diaphoretic and/or hairy skin. You have to work on both the down and upstrokes and most guys can only go for about two minutes, so manpower will really need to be used on CPR calls.

I like the valve's metronome and led timing light feature, it really helps you keep rhythm and the metronome gets you in a zone so you tend to forget how tired you're getting. This will work well in our fire department oriented EMS system as we use both paid and volunteers and most guys will get to the station when we get the CPR calls during the trials knowing that a lot of manpower will be needed.

[dzmohr]

Several posted here last year about the ResQPod and suction cup CPR - Whatcom County and the Twin Cities were doing studies, any update? The ResQPod was a hit at the Citizen CPR conference in Florida a few weeks ago and is touted in this month's JEMS....how are they working in the field?