Research Day
COMPARISON OF PRE-HOSPITAL ROSC RATES FOR MANUAL-ONLY VS MECHANICAL-ASSISTED CPR USING THE LUCAS-2: A RETROSPECTIVE STUDY
Document Type
Abstract
Date
2021
Abstract
Introduction: Annually, more than 350,000 out-of-hospital cardiac arrests (OHCAs) occur in the US. CPR has been shown to improve survival. Mechanical CPR (mxCPR) devices have been introduced to improve CPR quality. The American Heart Association states mxCPR can be considered in specific settings. Existing studies involve multi-jurisdictional populations and have yielded mixed results. We focused our study on a single fire department jurisdiction encompassing a large midwestern city served by a single ambulance provider and hypothesized that within this setting, the implementation of a LUCAS-2 mxCPR device would increase the pre-hospital ROSC rate as compared with manual CPR (mCPR).
Methods: Retrospectively, nine years of adult non-traumatic OHCA data were extracted from the ambulance provider ePCR. Chi-square analysis compared ROSC rates before and after LUCAS-2 implementation. Logistic regression assessed the impact of Utstein variables on ROSC. Results: From initially 857 OHCAs, 264 (74 pre-LUCAS) met inclusion criteria. ROSC rates were 29.7% (22/74) and 29.5% (56/190), respectively, for mCPR and mxCPR (p=0.9673). Logistic regression revealed ROSC was significantly associated with a witnessed arrest (OR 3.1; 95% CI 1.9-5.1; p<0.0001), and an initially shockable rhythm (OR 2.8; 95% CI 1.5-5.2; p<0.0013).
Conclusions: There is no significant difference in non-traumatic adult OHCA ROSC rates among patients receiving mxCPR vs mCPR. Systems with limited personnel might consider augmenting their resuscitations with a mxCPR device, although cost and system design factors should be considered. Secondary analyses suggest that OHCA patients with a witnessed arrest or an initially shockable rhythm, have a higher likelihood of attaining ROSC.