Sep 20

Autopulse

 

We're trialling a mechanical CPR device. Imagine an ironing board that you lie the patient on and it does chest compressions for you.

We tried it on resusci annies, then we tried it on full size dummies.

And then we took it to the fire college and hauled their 80kg rescue dummies up and down a six storey training tower, all soot and stairs and haunted leaning furniture, while the machine hammered on their sternums a hundred times a minute.

People always complain that we don't test gear “where you'll use it, in a high flat, or down a stairwell.”

 

We tested it.

 

Then, three days ago, I hauled ass to a cardiac arrest and strapped it across the chest of a woman who we all suspected wouldn't make it out of the house, let alone to hospital.

And it cramped and squeezed her chest and poured blood into her heart muscle which began to twitch and then beat as normal.

And that heartbeat produced enough blood pressure to push oxygen to her respiratory centres and she started breathing spontaneously.

And instead of leaving a corpse on the landing for the mortuary workers to zip into a black bag and bump down the stairs?

We took a very sick mother, wife and sister to hospital and called her family to come say goodbye.

 

 

 

19 Responses to “Autopulse”

  1. EmilyT says:

    I worked at the Stadium during the Olympics and we had one of those available there. It was demonstrated on a dummy to those of us that had never seen one before so we would know how to use it. Amazing bit of kit if you’re looking at it from a medical point of view. Horrendously noisy and scary if you’re not though!

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  2. GrumpyRN says:

    HI Kal, I’m assuming you don’t mean a ‘thumper’? We’ve had one of these for years and use it in extended CPR – usually following drownings, (your not dead until your warm and dead). Only drawback with the thumper is it requires an O2 supply.

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  3. GrumpyRN says:

    Just had a look at your photograph after pressing submit, I see that it seems to be some kind of belt round the patient. Is it air or battery driven?

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  4. Nickopotamus says:

    “We took a very sick mother, wife and sister to hospital and called her family to come say goodbye”.

    The Autopulse is a great bit of kit in general, and although I haven’t looked at whether it does increase survival to discharge rates, anecdotaly it has worked for me. But is this case, is this outcome really an improvement for this patient?

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  5. Nickopotamus says:

    GrumpyRN: Battery driven. Tends to break down a fair amount. See http://www.zoll.com/medical-products/cardiac-support-pump/autopulse/.

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    Rosetintdscrubs Reply:

    Some of the initial issues with the batteries working pretty poorly in cold weather have apparently been resolved – which is good. That was a pretty limiting feature when the batteries have to be stored in the back of a cold ambulance or aircraft.

    Anecdotally it’s also worked reasonably well for me, particularly when extracting patients in a manner which would otherwise be impossible with CPR ongoing. Zoll make a rather nice carry-sheet-type-thing which it clips into.

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    Rosetintdscrubs Reply:

    Oh, and also it works with Zoll’s rather impressive new see-through-CPR: compatible monitors subtract the CPR waveform from the ECG, allowing you to read the patient’s rhythm, and shock the patient with CPR ongoing.

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  6. Win-Stone says:

    As a non-medical type, I’m assuming that you’ll worry later about that fact that the patient appears to have had their arms ripped off? :-0

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  7. Sebbie says:

    I really wonder why we put patients through some of the things we do sometimes. There are people like Fabrice Muamba who defy the odds but for the majority are we just trying to delay the inevitable? I’ve x-rayed people everyone knows is dying and I wonder why instead of making people comfortable and easing their passing we intervene again and again.

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    Sam Reply:

    I heard this device was used on Fabrice. What a great story that he survived.

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  8. Lucy says:

    Two questions:

    1) As it is a constricting belt type device, how well does it work on those who are a bit ‘endowed’ around the front of the chest area?

    2) Do you still feel compelled to move to the beat in the same way you did to the ‘Thumper Rap’?

    Personally I’m a huge fan of automated devices for delivering consistent, controlled CPR and obviously this one has shown its worth in this test. However, from memory old Thumper seemed to be ‘off sick’ more often than he was available for duty! If the autopulse is a robust and reliable bit of kit then all praise to it but if as Nickoputamus notes it cant hack the pace then it could cost more repairs than in earning its keep.

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  9. Aoife says:

    We have a LUCAS machine where I work and it’s pretty good! Apparently it doesn’t matter if you’re well endowed in the chestical region or if you’re obese (our rep said it would fit 9/10 americans) It can be also used in the cath labs as you can screen through it which is pretty useful as I work in a hospital that has a large primary angio service and cardiologists who refuse to believe rigor mortis is indicative of a poor outcome…

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  10. Gary says:

    I’m of the opinion that using this device will ensure that the correct depth and rate of compressions will be achieved. It will also free up the medic to enable him/her to cannulate a vein,administer drugs and allow him/her to focus more on the H’s and T’s. I’d love it if I could get one of these where I work.

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  11. James says:

    Are Brc getting it? :P

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  12. student paramed says:

    My self and another student did a massive research assignment on this device last semester – all research (that we could find) showed it to be fantastic. Improved survival rates, no broken ribs, vastly improved venous return (when compared to manual CPR). Ambulance Victoria (Australia) are planning to do a study in the near future….
    I’m hopeful that I’ll get to use it someday – it could make such a difference in rural ambulance where personnel are limited and transport time is lengthy.

    I just realized how this reads. I promise I don’t work for Zoll…

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  13. Nathan says:

    Ive only seen this in use in A&E on a elderly gentleman – id almost call it barbaric. I can see its use prehospitally when there aren’t enough hands but in a hospital setting when there’re enough people around to do CPR rotations it came across as a bit harsh (on the first squeeze the it jerked the guys upper torso upwards almost knocking out the anaesthetist!)

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  14. Phil says:

    I had cause to be in Edinburgh for a few hours during the festival. Wandered to the Mile. But among all the artists and escapologists and Yoda. Found myself looking for an erudite Scottish lad in high-vis riding a bike

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  15. Ruth says:

    I am a german EMT and we use the LUCAS device as well… I was quite amazed when we first got it, because it really does great CPR, no comparison to manual compressions. I work in a rural area, which means it sometimes takes us a while to get a patient to an adequate hospital and doing good CPR for maybe 30 or 40 minutes is impossible for a person but no problem for the device… BUT I have seen several patient that were simply to big for the device. It sorta looks like a belt strapped around the chest and I would think that probably half of the patients we try to resuscitate would have been to big for it… So there’s still room for improvement there…

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  16. Ellie says:

    Horray! We just got one for my service. Good for patients and no one was in danger doing cpr in the ambo.

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