The Big Squeeze
Life-saving technology provides Mary Greeley paramedics an extra set of hands when treating heart attack patients.
By Andrew Zalasky
Mary Greeley Medical Center paramedics were racing to an emergency call when they got an update on the situation from Ames Fire Department: A middle-aged man was in cardiac arrest.
The LUCAS2 device, carried in
Mary Greeley ambulances, can perform
chest compressions, freeing
paramedics to do other potentially
Firefighters who responded first to the 911 call had performed CPR and used a defibrillator on the gentleman, but when hospital paramedics arrived, they quickly realized he had no shockable heart rhythm. They immediately reached for the LUCAS2, a new device carried in Mary Greeley ambulances that can perform chest compressions, freeing paramedics to do other potentially life-saving procedures.
As the LUCAS2 performed compressions, paramedics handled the monitor-defibrillator. Still not able to find a spontaneous pulse, the crew loaded the patient onto the ambulance as the LUCAS2 device continued with compressions.
By the time the team arrived at Mary Greeley’s Emergency Department, the patient’s pulse had returned. The patient survived the heart attack due, in part, to the role played by the LUCAS2.
Ready in Seconds
For decades, the recommended first course of treatment for cardiac arrest patients has been manual CPR (cardiopulmonary resuscitation) provided with consistent timing and just the right amount of pressure. The LUCAS2 does just that: It performs compressions with the perfect amount of pressure at the flip of a switch.
“For the treatment of cardiac arrest patients in an out-of-hospital setting, the LUCAS2 represents a significant advancement,” says Chris Perrin, supervisor of Mary Greeley Medical Center’s paramedic services. “The device augments blood flow better than anything I’ve seen in emergency care.”
“This puts our paramedics at an elite level
in terms of treating cardiac arrest in an
- Dr. Jonathan Burns,
McFarland Clinic Emergency Medicine
The LUCAS2 device fits in an unassuming case, about the size of a backpack, making it easy to store and access on the ambulance. The unit includes a rigid, contoured board that slides under the patient. The bright yellow top of the device has two wings that open up and secure to the board under the patient. The top of the device carries the rechargeable battery and includes a plunger with a suction cup that performs the compressions.
“The suction cup is a huge benefit of this device,” Perrin says. “It allows the device to pull the chest back up after performing a compression. This greatly improves blood flow and leads to better patient outcomes.”
Perrin says the device can be deployed, secured to the patient and activated in less than a minute. He says it is capable of doing a little more than 100 compressions per minute — and it never gets tired.
“That is the primary thing,” Perrin says of the consistency of the LUCAS2. “As care providers, we’re human. It would be impossible for us to provide the perfect compression, without rest, as long as it is needed. This device is just relentless. People get tired. This doesn’t.”
Dr. Jonathan Burns, McFarland Clinic emergency medicine, says consistency is what carries the day when it comes to caring for cardiac arrest patients.
“The LUCAS2 allows both pre-hospital and in-hospital providers to offer the highest quality CPR to cardiac arrest patients,” he says. “One of the biggest changes to the American Heart Association (AHA) guidelines recently has been a major push toward the provision of high quality, uninterrupted chest compressions. This has been shown to be one of the most important factors in having a favorable outcome in cardiac arrest patients. With the LUCAS2, we can provide this consistency with minimal interruptions.”
In addition, the LUCAS2 device frees up members of the care team to attend to other critical needs.
“The LUCAS2 enables us to turn the compressions over to the device so we can focus our resources on other aspects of the resuscitation and provide critical care to the patient,” Burns says. “This puts our paramedics at an elite level in terms of treating cardiac arrest in an out-of-hospital
The LUCAS2 “greatly increases the effectiveness of resuscitation and helps us provide the best care possible to heart attack patients,” says Perrin. “I firmly believe it increases the survival chances for these patients.”
“The art and science of saving lives is multi-faceted enough that I’m not sure I could attribute a life saved just to this device,” he says. “But every improvement we have in early-resuscitative care certainly helps improve outcomes.”
And Burns sees the use of the LUCAS2 and similar devices expanding to inpatients in the future.
“We have used the LUCAS2 for inpatient cardiac arrest,” he says. “I would expect that trend will continue as providers become more familiar with the device over time.”
Coupled with other recent advances in treatment and the adoption of advanced technologies, Burns says heart attack patients in central Iowa stand a better chance of survival now than at any time before.
“The addition of the LUCAS2 device, our community-wide push toward increasing Automated External Defibrillator placement, and our post-arrest cooling protocols have combined to make Mary Greeley Medical Center comparable with the top hospitals in the country in employing the science of early resuscitation in the treatment of cardiac arrest,” says Burns.