Out-of-hospital use of an automated chest compression device: facilitating access to extracorporeal life support or non-heart-beating organ procurement.
OBJECTIVE
The aim of the study was to assess the ease-of-use, safety, and usefulness of an automated external chest compression device for cardiopulmonary resuscitation.


METHODS
Adults with out-of-hospital cardiac arrest (OHCA) were included prospectively. The emergency medical services (EMS) in a large suburb northeast of Paris (France) recorded data for standard criteria for EMS care for CA and specific criteria on device use-application time, ease of application and use (visual analog scale score: 0, impossible; 5, very easy), technical incidents, and clinical complications.


RESULTS
We attended 4868 OHCA patients (January 2005 to April 2010) and used the device in 285 patients (6%) (212 males [74%], 73 females [26%]; median age, 56 [43-70] years). Results (medians with 25-75 percentiles) were as follows: time to apply device, 30 seconds (20-60); ease of application and activation, 5 (4-5) and 5 (5-5), respectively; duration of use, 30 (20-41) minutes; return to spontaneous circulation (ROSC), 76 patients (27%); and time to ROSC, 19 (12-32) minutes after placement. Twenty-seven patients (9%) with refractory CA benefited from extracorporeal life support. Overall, 32 patients were alive after 24 hours, 11 at 7 days, and 3 at 1 month. An additional 23 patients (8%) with refractory CA were selected for non-heart-beating kidney procurement. Ten patients were used to harvest kidneys and 15 were transplanted. There were 21 technical incidents (7%) and 19 clinical complications (7%).


CONCLUSIONS
The device was easy to use in routine emergency practice and of particular value in facilitating access to extracorporeal life support or non-heart-beating organ procurement. These uses should be itemized in all OHCA studies.
Hopital Avicenne, Bobigny, France.
Jean Marc
JM
Agostinucci
Mirko
M
Ruscev
Michel
M
Galinski
Serge
S
Gravelo
Tomislav
T
Petrovic
Cyril
C
Carmeaux
Hakim
H
Haouache
France
F
Roussin
Frédéric
F
Adnet
Frédéric
F
Lapostolle
D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods; D004632:Emergency Medical Services / Q000379:methods; D005112:Extracorporeal Circulation / Q000706:statistics & numerical data; D005260:Female; D006336:Heart Massage / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D011446:Prospective Studies; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data; D016896:Treatment Outcome