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Up, down. Up, down.
That’s how a person does CPR, cardiopulmonary resuscitation, when another person can’t breathe. Paramedics at Greater Regional Medical Center now have a LUCAS CPR machine to do that for them while they care for any patients in other ways.
“A LUCAS CPR machine is a device that does the compressions for the responders,” said Ryan Burwell, EMS manager at Greater Regional Medical Center. “This one is made by Physio Control. It does the compressions, and it does them consistently, so you get the proper blood flow to the heart and the lungs.”
Burwell, who has been in emergency medical services for 17 years, spent time in Clarinda and Shenandoah before joining the team at Greater Regional. He has been at the hospital for 15 years.
LUCAS
The machine has two parts: the board that goes behind the patient, and the top half where the piston and buttons are. The two connect, and must be separated manually.
“It has this nice piston design, so you can set your depth per person,” Burwell said. “With this, you can set it either to your 30 to 2 compressions, or continuous compressions.”
Currently, compressions should be done 30 times to a patient, then two breaths should be given for an adult in any form of cardiac arrest, like a heart attack. Children and infants should have 15 compressions before breaths are given. Compressions should be approximately one and a-half to two inches in depth.
With the use of the CPR
machine, responders are relieved of the physical stress and can focus on other aspects of caring for the patient.
“It leaves a rescuer to have more hands,” Burwell said. “Right now, CPR takes more than one person, and after about two minutes of good CPR, the responder, either being a fireman, a police officer, one of us (medic), you’re beat. You don’t do the proper depth. It’s just hard to do the constant CPR they need.”
Working
To work the machine, separate the two parts and fit the board under the patient. The top half connects to the bottom at the sides. The responder will then push the correct buttons on the top half of the machine to either do consistent compressions, or at the 30 to two compression ratio.
“Once it’s on, you go ahead and push the start button, and it’ll go,” Burwell said. “Then, after your two minutes, you can push the pause button. At that point, you can look at the monitor and look for a pulse, and go from there.”
The LUCAS machine is relatively new, but statistics show success rates are high compared to manual CPR. According to statistics printed on the machine website, over the course of 33-40 minutes of resuscitation, manual CPR has a success rate of 78 percent, while the LUCAS machine has a rate of 91 percent.
Statistics also show manual CPR hands-on time decreased from 81 percent on-scene to 73 percent during transport because paramedics had less room in the ambulance and still had to watch out for themselves working in a moving vehicle. The LUCAS machine success rate stayed relatively the same on-scene and during transport.
“CPR is what saves lives. If someone goes down, it’s the CPR prior to us getting there, it’s what gets the oxygen pumping,” Burwell said. “It can be five to 10 minutes on an ideal day (until paramedics arrive), and if someone witnesses the arrest, it takes five minutes for oxygen to get out of the blood. CPR is what actually saves people.”
Greater Regional
Greater Regional’s CPR machine will be stored on the hospital’s first ambulance on scene, and there are plans to possibly purchase two more machines for the second ambulance and ER.
Personnel at Greater Regional did research before the purchase to figure out which model to buy. Several paramedics also work in other counties, and had the opportunity to use different models elsewhere. Eventually, the LUCAS machine was chosen.
So far, the machine has been used twice in Creston, and has been relatively successful.
“People seem to like it,” Burwell said. “Any code situation, when we have to do CPR and things like that, that would be the only time we would use it.”
Set-up for the machine should take approximately 20 seconds, and usually responders would use continuous compressions with a breathing apparatus in place on the patient during CPR. Any shocking device can also be used while the machine is in place.
Burwell said the only possible disadvantage to having the machine would be hauling it on scene, since responders also have other bags and equipment to carry. Responders can carry up to six bags to a scene.
However, the machine is small enough to work with the current equipment responders already use.
“Carrying patients out (on a gurney), you have to stop to get through the doorway. This is the right width, it’ll go through doors. There’s no stopping,” Burwell said. “Our plan is, now that we have it, we’re kind of a little more familiar with it. We wanted to find a time to meet with Todd (Creston Fire chief) and those guys, because there’s going to be a time when they help us.”
Using the machine will certainly depend on the nature of the call, such as if a person is unresponsive or if someone fell down the stairs. If needed, responders will always start with manual CPR before switching the patient to the machine. Plus, any information first responders or those calling in the emergency can give Union County dispatchers, the easier it is for paramedics to do their jobs.
“What I’m hoping is that we’re going to get more people back from cardiac arrest with it,” Burwell said. “It’s better patient care. You know, you can do more with less.”