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The Resus Room

Mechanical CPR

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8678 Ratings

🗓️ 15 June 2017

⏱️ 21 minutes

🧾️ Download transcript

Summary

High quality manual cardiopulmonary resuscitation (CPR) with minimal delays has been shown to improve outcomes following out-of-hospital cardiac arrest (OHCA). There are concerns that the quality of CPR can diminish over time and as little as 1 minute of CPR can lead to fatigue and deviation from the current recommended rate and depth of compressions.

With this in mind, a mechanical device to provide chest compressions at a constant rate, depth and without tiring has considerable theoretical benefits to patients, yet clinical equipoise remains about the role for this treatment modality.

In this podcast, we discuss and critically appraise 2 randomised controlled trials (RCTs) set out to answer exactly that question and give our take on the role for mechanical CPR devices in the future

Hope you enjoy and feel free to leave any feedback below!

Rob

References 

Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. Perkins GD. Lancet. 2015

Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial. Rubertsson S. JAMA. 2014

Transcript

Click on a timestamp to play from that location

0:00.0

Welcome to the Recess Room podcast.

0:03.9

Five, four, three, two, one, fire.

0:13.1

So hi, and welcome back to the Recess Room podcast. I'm Simon Lang.

0:18.2

And I'm Rob Fenwick. Fresh back from microphone gate, everything appears to be working absolutely fine.

0:24.4

Thank you for mentioning it on Twitter.

0:26.1

It's funny how you always mention that at the beginning of a podcast and we always have to edit that out.

0:32.8

That is not true.

0:34.0

That is the sole time that I've been responsible for that problem.

0:38.0

There are many other problems that I've been responsible for, but we'll forget about that.

0:41.4

Post-production is a beautiful thing. Right. So this is all about you again.

0:48.4

So tell us what we're discussing today, Rob.

0:50.8

So today's time we're going to be having a discussion around mechanical CPR devices,

0:56.0

so specifically the Lucas device. So you've been looking at this in your masters, haven't you?

1:00.8

That is entirely correct, yep. So I've been living this subject for the last few weeks.

1:06.0

Specifically, we were asked to address the research question, so develop one. So using a PICO method, the research

1:11.9

question that I developed was this. Does mechanical CPR with the Lucas device improve mortality

1:18.2

over manual CPR in adults without of hospital cardiac arrest? Okay, so before we actually get down to the nitty- gritty of the evidence-based medicine, why is it actually worth thinking about it in the first place, Rob? I mean, I'm not looking to challenge your whole project, but what's the sort of context that we're thinking of using mechanical CPR in? Because we all practice ALS and obviously in ALS, there is not the mandate to use mechanical CPR.

1:45.8

So what's the thinking behind it?

1:47.5

Yeah, so that's a good question.

1:48.7

I mean, the simple thing was in terms of a topic, it was a topic that was really interesting

1:53.2

to me and it's something that I see done fairly frequently around my region, particularly

1:57.7

with the Lucas device.

...

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