Medicine comes full circle, again.

[ERDoc]

We had a device rep from Physiocontrol come to the ER the other day and show us this new and amazing device called the Lucas2 CPR device. It's pretty impressive and fun to play with. As I'm pushing all of the buttons like a 5 year old in an arcade, a little flicker sparks in a dark part of my memory that says, "Hey, you've done this before." Suddenly the memory comes back, almost 20 years ago to the day, that I became Thumper certified. For those not old enough to remember, the Thumper was this barbaric CPR torture device that was all pneumatic and sucked down O2 tanks like no COPDer ever has. Here's a pic

Ah the good old days of EMS. I still have my Thumper Certified patch hidden somwewhere. Funny how things change, yet stay the same.

[island emt]

The lucas is nothing more than a modern day thumper.

I'm pretty sure the original thumper is still marketed. They could suck down a pair of "E" tanks in 10 minutes

Unfortunately modern studies have shown a small or negative outcome in arrests where a mechanical compression devices are used.

We bought the Zoll auto pulse system 5 years ago, and had some reasonable success with it. being able to palpate a pulse in a cardiac arrest pt tells me that it does improve perfusion.

However the state has decided that even though they initially approved it for use, now they have removed it from approved devices list.

Some areas have had better results than others with mechanical compression devices.

[emtdennis]

Speaking of cpr, what is anyone's thoughts on the "new" process being taught by the AHA? If I understand it correctly it is soo easy to do by the average citizen. I am just not familiar with it yet. Hoping to take lessons within a couple of weeks. There is no certification involved for the average person, but it may at least keep things flowing for the patient til EMTs can get there.

Edited April 18, 2013 by emtdennis

[island emt]

Basically it is push hard & fast until you either gain ROSC or until your too exhausted to continue.

Airway is moved way down the algorithm.

[Secouriste]

In France, we still teach people to perform a 30/2 CPR...

The Lucas CPR devices are used by some EMS here, especially the SAMU who are 2 or 3 and had to handle a full procedure on scene... alone. Those are also quite handy if an emergency transport is needed (for instance, if the person cannot be stabilized on scene). In big cities they're not used, you'll mostly find them in the rural areas.

The EMT-B aren't using them.

[HellsBells]

We trained on the thumper in EMT school.

[Akmedic07]

We use the auto pulse with good results when the battery works. Had some issues initially but once we instituted the correct battery maintenance we are having better luck. When you have limited personnel and long (greater than 20 minutes)transport they are very helpful. We have had a couple true saves (patient left the hospital) but size of the patient can be an issue. Re your discussion regarding hands-only CPR.. great for lay folks but for providers we should still try to get air in AFTER good compressions are started.. From my research it is emphasized that we need to get those 0's moving as quickly as possible.

[mobey]

.. From my research it is emphasized that we need to get those 0's moving as quickly as possible.

I don't get the reference... What's a 0?

[Bieber]

Seems like an expensive alternative to changing out compressors frequently, keeping interruptions to <10 sec, metronomes, eliminating non-critical (defibrillation) tasks on cardiac arrests...

Just my $0.02.

Speaking of cpr, what is anyone's thoughts on the "new" process being taught by the AHA? If I understand it correctly it is soo easy to do by the average citizen. I am just not familiar with it yet. Hoping to take lessons within a couple of weeks. There is no certification involved for the average person, but it may at least keep things flowing for the patient til EMTs can get there.

We've been using compressions-only CPR (at least for the initial 6 minutes) here for a couple of months with tremendous results so far. We've also stopped pausing compressions for anything other than rhythm/pulse check and defibrillation and eliminated the requisite for advanced airway placement even later in the code.

It's good stuff, I'm glad the AHA's pushing it on the lay folk, but I'll be even happier when they push it on professionals as well.

We use the auto pulse with good results when the battery works. Had some issues initially but once we instituted the correct battery maintenance we are having better luck. When you have limited personnel and long (greater than 20 minutes)transport they are very helpful. We have had a couple true saves (patient left the hospital) but size of the patient can be an issue. Re your discussion regarding hands-only CPR.. great for lay folks but for providers we should still try to get air in AFTER good compressions are started.. From my research it is emphasized that we need to get those 0's moving as quickly as possible.

Did you mean "get those O's", as in oxygen, in as quickly as possible? I haven't read any research that indicates anything other than passive insufflation is needed in the setting of cardiac arrest. What have you read?

[ClutzyEMT]

Speaking of cpr, what is anyone's thoughts on the "new" process being taught by the AHA? If I understand it correctly it is soo easy to do by the average citizen. I am just not familiar with it yet. Hoping to take lessons within a couple of weeks. There is no certification involved for the average person, but it may at least keep things flowing for the patient til EMTs can get there.

I just started using the new "CPR Anytime" DVD in our local schools

In total honesty, initially I was very disappointed in it~but then I've been trained the way of the dinosaurs and still want to teach ABC....

There are a few things I would like to see modified in it, such as maybe checking for a pulse added back in there but that is because "we've always taught it that way"....and it's hard to unteach an old dog old tricks I guess

What completely reversed my opinion on it was the "score" sheets that were returned to me at the end of the day~I had an increase of 66% of students that said they would actually feel comfortable having to do CPR on a family member or friend and an 82% increase in students that said they would use it on a total stranger!! Yeaaa **throws arms in the air and does the happy dance**

Random comments heard through out the day pointed towards the students being more comfortable with it since they didn't have to worry about doing mouth to mouth anymore. That issue was brought up several times during the day~and I know from teaching it in the past, that the mouth to mouth was daunting to many of the students and one of the things they didn't want to do~~

Also, from my recent CPR/AED "save", I know that airway was approximately ten minutes into the resus process as the gentleman had lacerated his forehead when he fell, which in turn caused his entire face to be full of blood and not having a pocket mask, or BVM nearby, I didn't get to do ventilations on him until someone brought me a first responder bag out of the facility where we were that had a BVM in it...so this gentleman didn't get ventilations prior to his first shock and still survived to walk out of the hospital with a pacemaker two weeks later...

The "Anytime, Anywhere" AHA video is very lay person friendly, and it does a lot of stressing of the "Push hard and push fast" mantra and stresses that people who suffer SCA need someone to do something besides standing there in a panic... So in my own humble opinion, if it gets two people out of five to actually begin CPR, it can only improve someone's chances of surviving a cardiac arrest and I am all for teaching it as often as possible to as many people as possible......

Oh...and I remember the 'original' thumper as well and I'm sure I have a jacket with my pretty patch on it somewhere in a box in my storage

We purchased three of the new Zoll Auto pulses quite a few years ago at the reservation where I worked, one for each rig, and I'd be willing to bet that all three of them were used a total of about ten times....the one in the main rig was used the most of course, and one code I used it on in particular, the batteries gave out ten minutes into the code . It gave me enough time to get an IV and an airway secured but then I was back to trying to do it all by myself again since we didn't run with partners~~and the "back up" battery was flawed.

I used it a couple times after that as well but not "religiously" because I found it a major pain in the ass to access!! The things were so big and bulky that there was really no handy spot in the rig to put it so that we could get to it in a hurry. It rode behind the passenger seat in the front of the rig and you almost had to pull the damn seat out of the rig in order to get to it. Only one of the rigs had a spot on the inside of the rig near the patients feet that it could be secured into and be handy enough to grab, but that rig was the "third out" rig and unless we were paged out specifically for a cardiac arrest or CPR in progress, we didn't use that rig very often and had to use the GSA rig, where it rode up front.....