title: A case of hypothermic cardiac arrest treated with an external chest compression device (LUCAS) during transport to re-warming.
abstract: The recommended treatment for severe hypothermia with circulatory collapse is re-warming using cardiopulmonary by-pass. This may require transporting a patient to hospital with on-going cardiopulmonary resuscitation (CPR). Manual CPR during patient transport may result in sub-optimal chest compressions and can be a hazard for the ambulance crew. We report a case of a patient with a core temperature of 22.2 degrees C and crew-witnessed cardiac arrest due to hypothermia. After unsuccessful initial resuscitation he was transported to hospital for re-warming with cardiopulmonary by-pass. CPR was continued during transport using a mechanical active compression-decompression device (the LUCAS-device). During cardiopulmonary by-pass ROSC was achieved after 90 min of cardiac arrest. The patient recovered with a cerebral performance category of 3. Using a mechanical device for chest compressions during transport of a hypothermic patient with on-going CPR is feasible, effective and safe.
authors.affiliation: Helsinki Emergency Medical Services, Helsinki University Central Hospital, Helsinki, P.O. Box 112, FIN-00099 Helsinki City, Finland. peter.holmstrom@hel.fi
authors.forename: Peter
authors.initials: P
authors.lastname: Holmström
authors.forename: James
authors.initials: J
authors.lastname: Boyd
authors.forename: Marko
authors.initials: M
authors.lastname: Sorsa
authors.forename: Markku
authors.initials: M
authors.lastname: Kuisma
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods; D003131:Combined Modality Therapy; D004632:Emergency Medical Services / Q000379:methods; D004867:Equipment Design; D004869:Equipment Safety; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006336:Heart Massage / Q000295:instrumentation*; D006801:Humans; D007035:Hypothermia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D017694:Rewarming; D018570:Risk Assessment; D016896:Treatment Outcome