Document Detail


The impact of a new CPR assist device on rate of return of spontaneous circulation in out-of-hospital cardiac arrest.
MedLine Citation:
PMID:  16036830     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The San Francisco Fire Department deployed an automated, load-distributing-band chest compression device (AutoPulse, Revivant Corporation) to evaluate its function in a large urban emergency medical services (EMS) service. A retrospective chart review was undertaken to determine whether the AutoPulse had altered short-term patient outcome, specifically, return of spontaneous circulation (ROSC). METHODS: AutoPulse cardiopulmonary resuscitation (A-CPR) was used by paramedic captains responding to adult cardiac arrests with an average +/-SD response time of 15 +/- 5 minutes. The primary endpoint was patient arrival to an emergency department with measurable spontaneous pulses. The manual CPR comparison group was case-matched for age, gender, initial presenting electrocardiogram rhythm, and the number of doses of Advanced Cardiac Life Support medications as a proxy for treatment time. Matching was performed by an investigator blinded to outcome and treatment group. RESULTS: Sixty-nine AutoPulse uses were matched to 93 manual-CPR-only cases. A-CPR showed improvement in the primary outcome when compared with manual CPR with any presenting rhythm (A-CPR 39%, manual 29%, p = 0.003). When patients were classified by first presenting rhythm, shockable rhythms showed no difference in outcome (A-CPR 44%, manual 50%, p = 0.340). Outcome was improved with A-CPR in initial presenting asystole and approached significance with pulseless electrical activity (PEA)(asystole: A-CPR 37%, manual 22%, p = 0.008; PEA: A-CPR 38%, manual 23%, p = 0.079). CONCLUSION: The AutoPulse may improve the overall likelihood of sustained ROSC and may particularly benefit patients with nonshockable rhythms. A prospective randomized trial comparing the AutoPulse with manual CPR in the setting of out-of-hospital sudden cardiac arrest is under way.
Authors:
Michael Casner; David Andersen; S Marshal Isaacs
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors     Volume:  9     ISSN:  1090-3127     ISO Abbreviation:  Prehosp Emerg Care     Publication Date:    2005 Jan-Mar
Date Detail:
Created Date:  2005-07-22     Completed Date:  2005-08-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  61-7     Citation Subset:  IM    
Affiliation:
San Francisco Fire Department, San Francisco, California 94107, USA. michael.casner@sfgov.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Advanced Cardiac Life Support / instrumentation*,  methods
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation / instrumentation*,  methods
Case-Control Studies
Emergency Medical Services / methods*
Equipment Safety
Female
Heart Arrest / diagnosis,  mortality*,  therapy*
Heart Massage / methods*
Humans
Male
Middle Aged
Probability
Retrospective Studies
Risk Assessment
San Francisco
Sensitivity and Specificity
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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