title: Ambient oxygen concentrations resulting from use of the Lund University Cardiopulmonary Assist System (LUCAS) device during simulated cardiopulmonary resuscitation.
abstract: BACKGROUND
  Supplementary oxygen is used routinely during cardiopulmonary resuscitation (CPR). High ambient oxygen levels from ventilation circuits have caused fatal fires and explosions. The Lund University Cardiopulmonary Assist System (LUCAS) device is driven by > 70 l min(-1) oxygen which is also likely to increase ambient oxygen concentrations and cause similar risk of fire and explosion. This study used simulated CPR with a LUCAS device to measure resulting ambient oxygen concentrations and assess safety of the device.
  
  
  METHODS
  Simulated manikin CPR using a LUCAS device was performed outdoors, inside an ambulance (ventilation off and ventilation on full power), and in a resuscitation bay. Ambient oxygen concentrations were measured over the apical and sternal defibrillation sites and midway between the two, at the head and 1m horizontally above the head. Recordings were made for 5 min when the LUCAS device was turned on and for a further 5 min when turned off.
  
  
  RESULTS
  Ambient oxygen concentration increased quickly in all four scenarios. Peak oxygen levels over the chest were highest in the resuscitation bay (36.7%) and lowest in the ambulance with ventilation on full power (33.8%). Oxygen levels decreased to baseline within 5 min of turning off the LUCAS device.
  
  
  CONCLUSIONS
  The use of oxygen to drive the LUCAS device results in a rapid increase in ambient oxygen concentration to levels likely to risk injury or death from fire. Ambulance services and hospitals using the device must be alerted to these dangers immediately.
authors.affiliation: South Central Ambulance Service NHS Trust, Highcroft, Romsey Road, Winchester SO22 5DH, UK.
authors.forename: Charles D
authors.initials: CD
authors.lastname: Deakin
authors.forename: Vinu
authors.initials: V
authors.lastname: Paul
authors.forename: Emma
authors.initials: E
authors.lastname: Fall
authors.forename: Graham W
authors.initials: GW
authors.lastname: Petley
authors.forename: Fizz
authors.initials: F
authors.lastname: Thompson
mesh_terms: D000552:Ambulances; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D002980:Climate; D004780:Environment, Controlled; D005107:Explosions / Q000517:prevention & control; D005390:Fires / Q000517:prevention & control; D006801:Humans; D008348:Manikins; D010100:Oxygen / Q000032:analysis*; D010102:Oxygen Inhalation Therapy / Q000009:adverse effects* / Q000295:instrumentation; D017751:Safety Management; D014691:Ventilation
chemical_list: D010100:Oxygen