Today we commenced trialling and training with the Lucas 2 automatic chest compressor device.
First it was formally introduced to our consultant Lucas Fox who had been concerned at talk around the base that ‘Lucas’ would be involved in a lot more jobs from now on…then we ascertained its fit both within our retrieval road vehicles and around the chests of our most thoracically gifted paramedics.
Now to see if it works as a helpful adjunct to our regular resuscitation of the arrested heart.
Scenario – 57 yr old man, collapsed on road whilst walking his dog. Road crew in attendance, patient in VF arrest, no pads on yet, CPR and being bagged with BVM.
Scene/Patient/Challenge – Team arrived, confirmed VF arrest and instigated defibrillation. Paramedic applied Lucas 2 while doc secured airway and instructed road crew to obtain IV access and administer drugs. Lucas paused at 2 minutes to observe rhythm and patient defibrillated back into NSR.
1. Effectiveness of Lucas 2 in providing cerebral and pulmonary perfusion. Patients have been known to regain consciousness and require sedation despite having no intrinsic cardiac output. It also renders ETCO2 as a prognostic tool in cardiac arrest useless.
2. Who should do what? It was generally felt that the paramedic should be the one applying the device whilst the doctor takes handover, attends the airway etc but this may need to be protocolled.
3. Dimensions/practicality: it was possible to intubate the mannequin without the laryngoscope handle butting the device. The device also fits into the road ambulance as long as the back board sits above the stretcher sides.
Team: Geoff Healy (doc), Bob Lisle (para), Dave Kidd (road crew), Digby Horne (road crew), Helen Ellis (STAR), Brian Burns (SRC), Cameron Marks.