2CHEER Study Algorithms

Here are the algorithms for 2CHEER focussing on minimising interruptions to closed chest compressions while placing the device on the patient.

Inclusion criteria
OUT-OF-HOSPITAL cardiac arrest (OHCA) which is refractory to standard advanced cardiac life support (ACLS) treatment

• age 12-70 years

AND meets ALL of the following criteria:

• the cardiac arrest is likely to be of primary cardiac or respiratory cause

• the cardiac arrest was witnessed by a bystander or paramedic or hospital staff member

• chest compressions commenced within 10 minutes

• initial cardiac rhythm of ventricular fibrillation (VF)

• immediate availability of a mechanical CPR device with paramedic staff

• the cardiac arrest duration (collapse to arrival at ED) has been < 60minutes

OR meets ONE of the following criteria:

• Severe hypothermia (<32°C) due to accidental exposure

• Severe overdose with β-blockers, tricyclic antidepressants, digoxin or other agents causing profound reversible myocardial depression and/or cardiac rhythm disturbance

• Any other cause where there is likely to be reversibility of the cardiac arrest if an artificial circulation can be provided (e.g. massive pulmonary embolism)

Algorithm