WEMS 45-Medics Recieves Generous Equipment Donation From Lewisboro VAC

[x635 4,066]

KUDOS to LVAC and the anonymous benefactor! These devices are really expensive, and to for someone to donate seven of them is significant. And kudos for passing them along to WEMS for their 45-Medics and their ALS ambulance. Northeastern Westchester will definitely benefit from these excellent devices.

From the WEMS Facebook page:

Yesterday, Westchester EMS received a very generous donation from the Lewisboro Volunteer Ambulance Corps. LVAC had received a donation of 7 Lucas 2 CPR devices and graciously distributed 4 of them to WEMS to be placed on our paramedic fly-cars and ALS ambulance. This donation will not just benefit the residents of Lewisboro, but all of the towns in our fly-car consortium. This donation will undoubtedly save lives. The original benefactor chooses to stay anonymous. WEMS is deeply indebted to that person and LVAC. The devices will be on the road soon.

What is the LUCAS CPR device?

LUCAS 2 Chest Compression System

The LUCAS® Chest Compression System is designed to help improve outcomes of sudden cardiac arrest victims and improve operations for medical responders. Performing at least 100 compressions per minute with a depth of 2”, LUCAS can be deployed quickly with minimal interruption to patient care.

Video of the device in action (video taken by me)

[Ladder44 73]

The Uconn Health Center Fire Dept in Farmington CT, which is a ALS fly care FD for a hand full of towns in the area, has them for 2 years now and has seen an increase of ROSC in pre hospital but im unsure of hospital outcomes, theyre great, they free up a person and are very consistent and dont get tired, going down stairs theyre great and in the back of the truck it makes for a safer ride for the attendents being seated more appropriatly.

[comical115 32]

I don't want to rain on the parade here, but the Lucas device hasn't been shown to improve outcomes...

http://roguemedic.com/2014/03/the-failure-of-lucas-to-improve-outcomes-in-the-linc-trial/

How about spending (a lot of) money on something that actually can improve outcomes, like more medics?

Just my 2 cents.

[FDNY 10-75 640]

I don't want to rain on the parade here, but the Lucas device hasn't been shown to improve outcomes...

http://roguemedic.com/2014/03/the-failure-of-lucas-to-improve-outcomes-in-the-linc-trial/

How about spending (a lot of) money on something that actually can improve outcomes, like more medics?

Just my 2 cents.

I have only seen 2 'large' scale studies comparing the use of the Lucas II and manual CPR, one was conducted in Europe, the other in the US. The European study indicated that there was almost no difference between mechanical and manual CPR in ROSC. While some people view this is a negative result for the Lucas, I have to disagree; citing, that the device frees up an extra person at the scene. This enables that provider to perform other interventions (while CPR is in progress) and should the patient be transported, less manpower is required to take the patient to the ED. With the Lucas and a transport vent in operation you can literally transport an arrest with one medic in the back, whereas with mechanical CPR you would need at least two people. It frees up resources in EMS systems that are already limited. While a matter of convenience for me or any other provider doesn't justify the price tag, it is an exceptionally helpful device when working an arrest.

The US study did indicate improved outcomes in patients that received mechanical CPR coupled with an impedance threshold device. It's not clear to me why Physio doesn't push the use of ITDs with the Lucas to improve outcomes but it ma have to do with copyright, advertising, etc. The Lucas 'haters' never seem to cite this trial conducted by the AHA.

[sympathomedic 383]

These CPR machines kind of make me nuts. By every meassure, they SHOULD be producing more viable saves. I am sure that with $$millions worth of sales, there are many studies going on so the two main manufacturers can clakim they have more saves, yet the numbers don't seem to be there.

That said, they are a HUGE convenience. They make arrests run smother, quieter and the scene less chaotic. I also think they contribute to arrests being run longer, which I think in some cases = better. They make moving the arrest pt safer, though I bet someone will comment that in the perfect world we don't transport arrests.

No matter how you slice it, this is a big positive for a large swath of Westchester. Yonkers has them and I know of several squads that are using sales demos. Seems just a matter of time that all CPR in Westchester will be done by machine.

[RWC130 594]

Lucas 2 CPR device works pretty well. I will STRESS one thing.... TRAINING!!!!!

If you can't set it up and use it correctly in a classroom then out in the field it will be

a cluster......and you will look totally UNPROFESSIONAL.

[Medibart 55]

I don't want to rain on the parade here, but the Lucas device hasn't been shown to improve outcomes...

http://roguemedic.com/2014/03/the-failure-of-lucas-to-improve-outcomes-in-the-linc-trial/

How about spending (a lot of) money on something that actually can improve outcomes, like more medics?

Just my 2 cents.

Each unit costs about $15K. If we were lucky to get 5 years out of one, that would be $3K a year. If you'd like to work for us full time for $3K a year, I'm sure we can find a position for you. Please check the Westchester EMS webpage for an application.

[STAT213 332]

Show me one piece of evidence that shows more paramedics equals better outcomes. Or one paramedic for that matter.

[sueg 77]

We just purchased 2 Lucas II devices and are having a training session tomorrow. It will definitely help with manpower, so we can worry more about getting people out of the houses and down or up stairs and into the ambulance without worrying about stopping compressions in between. The biggest factors for whether there will be a positive outcome, for manual or mechanical CPR, will always be how soon were we called after (or just before) the cardiac arrest, what caused it to begin with, how long before the first person arrives or CPR is initiated, when ALS is initiated, and how soon they can get to hospital for ultimate care/surgery/whatever needed to reverse cause or facilitate recovery.

Edited May 7, 2014 by sueg

[STAT213 332]

Additionally, there is ZERO evidence that advanced life support helps increase cardiac arrest survival outcome. Or surgery for that matter. With a very few exceptions, YOU will save their life in the field or they won't walk out of the hospital undamaged.

[sympathomedic 383]

Two observations:

Bob is 100% correct. You MUST PRACTCE the changover from manual to machine CPR. Not a slide show, not a table top, but on the floor, on your knees with a mannaquin, at least 3 times per member. EVERY member, not just the young bucks. When we got these (the Zoll model) in Somers, the difference in no-compression time between the very first round and the last round of practice was very significant- like enough to save v/s not save a person. I gamely assume we are all in this to do just that? So we all should make the effort to succeed, yes/no? Especially the Lucus, as it is difficult or impossible to to CPR while you are locking it in place. The Zoll allows for manual CPR to be done up until the last second. I like the Lucus better.

Secondly, the IAFF DID do some studies to try to prove that having FD on scene made pt outcomes better. They ran two scenarios, (a construction accident with obstructed access, and another one I can't recall) and did it (I think) 3 times each with several manpower configurations- BLS amb and 1 and then 2 medics on an engine, then 2 medics on an ambulance and EMT's on the engine, and some others (working with a fairly poor memory here, I bet $10 Barry knows the study and can post a link). What I recall they proved was that more medics on scene faster got pt care tasks accomplished faster. Since these were not done with actual sick/injured folks, there was no way to prove if faster task accomplishment = better outcome. I think they just wanted everyone to assume that that faster MUST BE BETTER, and therefore commit to have lots of firemen around. Just like we all want our bosses/budget makers to assume that if there are lots of usm, then we get to calls faster and have better care, even though in many cases we could double our response times with no significant negative impact. But as usual, I digress, sorry.

[mikeinet 37]

I think the manpower aspect alone is valuable.

Automated stretchers...those don't give any patient value, but save a ton of wear/tear/injuries on our EMS staff... as noted before, you now have an extra pair of hands to do other things than CPR (and get tired doing it...let's be honest, a lot of EMS isn't in "top shape" to do CPR continually for an extended period of time)

At a minimum... imagine two back to back codes and doing CPR and then still having another 5 hours on your shift...

Not debating there's actual patient value here too, but it looks like per the above there are studies that debate whether or not its worthwhile - so let's at least consider other positive aspects of this.

[amr6334 16]

_{^{Without knowing about WEMS I do have one quick question. Is WEMS a private ambulance service like Mobile Life Support Services or the like. If they are who pays a private company for equipment. Just out of curiousity and not trying to step on anyones toes.}}

[WAS967 97]

To the best of my knowledge: WEMS IS a private ambulance service but unlike MLSS/Transcare/etc WEMS is a not-for-profit organization. Just like any of the hospitals that participate in the Stellaris Network (also not-for-profit), WEMS can accept donations (tax deductible for the donor) of equipment, funds, and (wo)manpower.

Regardless, there is nothing that says you can't give money or equipment to a FOR PROFIT company. It's just not as advantageous however since it's not generally tax deductible.

[SRS131EMTFF 471]

Sounds like these units were given to the 3 (4?) fly cars that cover the 45-Medic area (NW Westchester).

[JackEMT 77]

A generous donation indeed. Did the agencies have any input into what was to be purchased, or did the donor say they wanted to purchase "a CPR machine" and it was up to the agency to pick the mfg/model?

If I remember right, LVAC benefited from a generous donation in the past and it was used for a large purchase. Someone can help me, was it for AEDs?

[newsbuff 286]

Sounds like these units were given to the 3 (4?) fly cars that cover the 45-Medic area (NW Westchester).

Given to the 3 fly cars and the 24 hour ALS ambulance that acts as a 4th medic when needed. The ambulance also does mutual aid to the surrounding communities on occasion.

[everybodygoes 331]

You can not compare a study that is done outside of your jurisdiction. Tx times to hospital and response times as well as time down all have a huge factor as well as the persons overall health. Having someone who works in a medical icu in a Trauma center the consensus is CPR generally doesn't help anyone unless it is a witnessed arrest. Usually they just waste away at the hospital as they have had such a long period of time with out o2 that they are a vegetable.

[amr6334 16]

everybody goes.....I completely agree with you. Ive seen people that should have been gone being held on to for some ray of hope. When my grandfather was in ICU at St. Johns (Yonkers), my mom and whole family wanted him to "stick around". My vote was let him go. Needless to say I became the black sheep and within a week his body listened to me.