Automated Chest Compression Devices

[Guest nickcabral]

Anybody out there currently using any of these devices such as the Zoll Autopulse? See autopulse here

I know there is also a pnuematic operated one which uses an SCBA bottle but the name slips my mind and an internet search provided no help. The companies who make these claim larger survivability rates when used with early cpr/defib, O2, and drug intervention.

I have seen the air powered one on CPR manikin as a demo and it seemed okay, however you need to lug around an scba bottle with you and the PT's arms get strapped to the device kinda like the victim is pointing to the ceiling.

Any feedback or experiences with these devices?

[Goose 188]

OLM in the North Bronx uses one on 15 Victor. At the time they started, they were the only unit in the city to use it.

[firemoose827 324]

Ive heard them called "Thumpers", and there are a few squads in our county who have them. They say it helps them out a lot especially with a crew of 2-3 and a transport time to the ER of at least 15 minutes. Counting your on-scene time and trasport time you could feasibly be doing compressions on someone for up to 45 minutes around here. These thumpers do adequate compressions consistantly, without fatigue setting in, and you can use your crew for other important things.

I have never experienced them first hand but what I have heard is decent.

Hope this helps some.

Moose

[Remember585 815]

I think Lake Mohegan FD had/ has one.

[Guest alsfirefighter]

Lake Mohegan has the autopulse. I've had it attached by the BLSFR FF/EMT's on every arrest I've worked there since they've had it and I've enjoyed its benefits. I believe that it does increase cardiac output and enjoyed the subtle benefits it also allows. Consistant compressions, no deflections or unequal depth while enroute (even though I do not transport code 3 for cardiac arrests and this also helps with manual CPR delivery) and the extra hands it allows. One thing that does irk me is a few ER nurses that want it ripped right off and one always said "someone give me real CPR please." How about getting some knowledge about a device first and see how beneficial it may be. I've had a handful of return of spontaneous pulses with the device and at a much higher percentage than in the areas that didn't. Hadn't had anyone walk out yet...but still makes you wonder if it is the device or not.

[JM15 386]

Somers FD has an autopulse on every ambulance. I have used it on a few occasions and it seems to work very well once you have it strapped on right.

[Guest Orpi442]

I have seen both used. Thumper is alittle diff & from way back. if you ever visit NCB or Jacobi you will see Thumper in the corner. Autopulse has some good out comes. Alamo had one for a trial period, but was never allowed to put it on my bus.

I am not sure it was even used there.

[paratrooper75 41]

I've used it a couple of times. Its great, especially when your short handed. The one downfall if any is that it can be a little violent so its important to watch that tube.

[Cos Cob 215 7]

In Greenwich, CT GEMS has device like this, I believe it is called and Autopulse. They say it is great when you are shorthanded and wish to continue compressions and can work while you are doing other things like placing the stretcher into the ambulance, carrying it down the stairs where there is limited access to perform good compressions, etc. Hope this helps.

Christian Andersen

Cos Cob Fire Police Patrol, Inc.

www.ccfpp.org

Edited July 5, 2007 by Cos Cob 215

[Guest alsfirefighter]

The other thing I wanted to add is that it also allows for continous compressions while moving the patient which is a plus.

In regard to the tube, I haven't had any problems with the motion, we utilize ambu tube holders which is better IMO than the Thomas type's and I also use a C collar on every arrest as well which also helps in every intubation scenario, particulary if you have a BLS provider providing ventilations and as what often happens to me is they pay attention to everything but where they are holding the tube...whether they are pushing in or pulling out, etc. The one semi issue I notice occassionaly with the ambu holder is that it can cause pinching and/or a great deal of pressure on the lips.

[Guest paramedico987]

Not too related, but thought I'd ask here...

ALS- I've had somewhat limited access to the thomas ETT holder for about a year now and LOVE IT! So much so, that I won't waste the only one I've got on an arrest that clearly has no good outcome [tape still works fine for dead people]

I've got 2 questions:

1] Does the ambu ETT device have a bite block? The incorporated bite block is one of my favorite features of the Thomas device... no more opening sealed bags of opa's!

2] What is the comparative cost of the AMBU vs. the thomas? The ambu LOOKS like it would cost less and if so then I've got a decent arguement for the boss to make the switch.

On a more related note... the literature [biased as it may be from the manufacturer] indicates an improved outcome for use of the "autopulse" and I think that its use is almost neccessary in the field given how we work. There's NO WAY that I can follow the new CPR/ACLS guidelines carrying someone down 3 flights in a reeves without one.

Real problem here is cost! Man are these things expensive!

[Guest paramedico987]

Nevermind my second question, ALS. I forgot I had a boud tree catalog here...

Thomas ETT Holder = $4.44 each

Ambut ETT Holder = $3.90 each

[Guest alsfirefighter]

The ambu holder also does have a bite block. Its been a while since I've handled or seen a Thomas ETT holder but for some reason I believe the Thomas might be a little longer then the ambu version. I don't remember if I had mentioned in my previous post but I like ambu's strap and the tube brace better than thomas.

[RadnorCo15 0]

So far we've had 3 uses with the Autopulse on the BLS truck...all 3 produced ROSC (Return Of Spontaneous Circulation).

[Guest]

This seems like a great product and seems like it has the potential of saving lives, but my question is to the agencies that have this is how much does it cost to have/maintain one of these, seems like ambulances should have this.

[Guest partyrock]

Randor, are you guys restricted in the application of the auto pulse? I know when they were first rolled out OLM was only using them on "savable" arrests. I'm not sure if that has changed, I don't get to run in the Bronx too often anymore.

[Guest Orpi442]

I know when they frist came out several years ago they where over $7 to 8,000.00.

[RadnorCo15 0]

The list price for this unit is about $15,000. I've been quoted prices as low as $8,500-$10,000 on various "deals." Refurbs are usually available at reduced cost as well as leasing/financing. Right now we are in a "phase 2" trial, we have the unit (at no cost) for 1 year.

The only restrictions we have on the use are the manufacturers recommendations for size/weight and traumatic codes. If the code warrents CPR, the device is applied. I see where you are going with the "savable;" certainly this device has the potential to revive patients with little or no brain function left.

On the contrary, this device has the potential to revive patients that normally wouldn't have a chance. The technology is truly remarkable. Unfortunately due to the cost I don't see it becoming "main stream" very soon.

[WAS967 97]

Regarding the tube holders: I have used both and each has it's pros and cons. I'll never forget the time I woke up an intubated respiratory arrest with narcan and had him bite right through the Ambu holder's bit block. Cheap plastic makes for a cheap holder. The Thomas one seems much more rigid. Downside to both is you can't use it for nasal tubes because of the bit block (if it weren't there on the thomas, it would work quite well actually - not sure of the mabu as I have not used it in a while. The definite pro of the ambu is the one handed use, just get the one with the velcro strap, not the blue rubber. I've actually had some problems with the velcro strap on the Thomas holder, but thaty can be overcome, since the more important part is the holder itself not the strap.

In the end it really comes down to personal preference, trying both out, and seeing what you like. Personally, I'd go for the Thomas. But either beats the pants off tape. YMMV.

As for the autopulse, I love it. It frees up hands to do other things. Only problem I've ever had with it is the strap breaking, but thankfully we were already at the ED. I still remember using the Thumper way back when Peekskill had one. Only thing I would miss about it is the fact that it "Breaths" as well and "pushes" for those patients who are intubated. But that just leads to a bored EMT on the ride to the hospital.

Cost will be a downside to the Autopulse for some time until they sell more units and it drives down the retail price. It has already come down a bit from when Mohegan original was part of the pilot program - they were $25k then I believe. So a few more years and I think they will become more and more common place, especially now with more and more emphasis being put on good chest compressions over all else.

Edited July 12, 2007 by WAS967