Implementation of a mechanical CPR device in a physician staffed HEMS - a prospective observational study

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine resuscitation and emergency medicine, 2018-04, Vol.26 (1), p.36-36, Article 36
• Main Authors: Rauch, Simon, Strapazzon, Giacomo, Brodmann, Monika, Fop, Ernst, Masoner, Christian, Rauch, Lydia, Forti, Alessandro, Pietsch, Urs, Mair, Peter, Brugger, Hermann
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aircraft; Analysis; Cardiac patients; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - instrumentation; Care and treatment; CPR; Emergency medical care; Emergency Medical Services; Extracorporeal membrane oxygenation; Female; Helicopters; Humans; Incidence; Italy - epidemiology; Letter to the Editor; Male; Medical care quality; Medical prognosis; Middle Aged; Observational studies; Out-of-Hospital Cardiac Arrest - epidemiology; Out-of-Hospital Cardiac Arrest - therapy; Patients; Physicians - supply & distribution; Prospective Studies; Retrospective Studies; Workforce; Young Adult
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/s13049-018-0503-4

In this prospective, observational study we describe the incidence and characteristics of out of hospital cardiac arrest (OHCA) cases who received mechanical CPR, after the implementation of a mechanical CPR device (LUCAS 2; Physio Control, Redmond, WA, USA) in a physician staffed helicopter emergency medical service (HEMS) in South Tyrol, Italy. During the study period (06/2013-04/2016), 525 OHCA cases were registered by the dispatch centre, 271 (51.6%) were assisted by HEMS. LUCAS 2 was applied in 18 (6.6%) of all HEMS-assisted OHCA patients; ten were treated with LUCAS 2 at the scene only, and eight were transported to hospital with ongoing CPR. Two (11.1%) of the 18 patients survived long term with full neurologic recovery. In seven of eight patients transferred to hospital with ongoing CPR, CPR was ceased in the emergency room without further intervention. Retrospectively, all HEMS-assisted OHCA cases were screened for proposed indication criteria for prolonged CPR. Thirteen patients fulfilled these criteria, but only two of them were transported to hospital. Based on these results, we propose a standard operating procedure for HEMS-assisted patients with refractory OHCA in a region without hospitals with ECLS capacity.