Abstract
Helicopter emergency medical services (HEMS) frequently respond to out-of-hospital
cardiac arrest (OHCA) situations. Some have speculated mechanical cardiopulmonary
resuscitation (mCPR) may be able to rectify the inadequacy of human performance of
cardiopulmonary resuscitation (CPR) during transport. A number of studies have examined
the performance of mCPR devices in the air medical setting specifically. Many aspects
of the HEMS environment seem uniquely conducive to mCPR, and a growing body of research
seems to suggest mCPR holds promise for the treatment of cardiac arrest by HEMS clinicians.
Simulation studies show that mCPR leads to improved CPR performance compared with
manual CPR in HEMS. Case reports and the experience of several HEMS programs suggest
that mCPR can be effectively integrated into HEMS care. However, further research
regarding the effectiveness of mCPR in the HEMS environment and in general cardiac
arrest care is needed.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Air Medical JournalAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Helicopter emergency medical service in out-of-hospital cardiac arrest–a 10-year population-based study.Acta Anaesthesiol Scand. 2000; 44: 972-979
- HEMS vs. ground-BLS care in traumatic cardiac arrest.Prehosp Emerg Care. 2005; 9: 79-84
- Helicopter emergency medical services (HEMS) response to out-of-hospital cardiac arrest.Scand J Trauma Resusc Emerg Med. 2013; 21: 1-5
- Polish helicopter emergency medical service (HEMS) response to out-of-hospital cardiac arrest (OHCA): a retrospective study.Med Sci Monit. 2018; 24: 6053
- The ability to perform closed chest compressions in helicopters.Am J Emerg Med. 1994; 12: 296-298
- Quality of closed chest compression in ambulance vehicles, flying helicopters and at the scene.Resuscitation. 2007; 73: 264-270
- Quality of cardiopulmonary resuscitation before and during transport in out-of-hospital cardiac arrest.Resuscitation. 2008; 76: 185-190
- The 4effect of transport on quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest.Resuscitation. 2009; 80: 843-888
- Rodríguez-Núñez A. Cardiopulmonary resuscitation quality by helicopter rescue swimmers while flying.Air Med J. 2016; 35: 288-291
- The efficacy of chest compressions in the Bell 407.Air Med J. 2019; 38: 281-284
- Effect of acute exposure to altitude on the quality of chest compression-only cardiopulmonary resuscitation in helicopter emergency medical services personnel: a randomized, controlled, single-blind crossover trial.J Am Heart Assoc. 2021; 10e021090
- Mechanical versus manual chest compression: a retrospective-cohort in out-of-hospital cardiac arrest.Acta Medica. 2021; 52: 325-331
- Quality of mechanical, manual standard and active compression–decompression CPR on the arrest site and during transport in a manikin model.Resuscitation. 1997; 34: 235-242
- Mechanical CPR devices compared to manual CPR during out-of-hospital cardiac arrest and ambulance transport: a systematic review.Scand J Trauma Resusc Emerg Med. 2012; 20 (-0): 1
- Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial.JAMA. 2014; 311: 53-61
- Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial.Lancet. 2015; 385: 947-955
- Manual cardiopulmonary resuscitation versus CPR including a mechanical chest compression device in out-of-hospital cardiac arrest: a comprehensive meta-analysis from randomized and observational studies.Ann Emerg Med. 2016; 67: 349-360
- No benefit in neurologic outcomes of survivors of out-of-hospital cardiac arrest with mechanical compression device.Prehosp Emerg Care. 2018; 22: 338-344
- Mechanical CPR: Who? When? How?.Crit Care. 2018; 22: 1-9
- Mechanical CPR devices: where is the science?.J Emerg Med Serv. 2019;
- Injuries after cardiopulmonary resuscitation: a comparison between LUCAS mechanical CPR and standard CPR.Resuscitation. 2008; 77: S13-S14
- CPR-related injuries after manual or mechanical chest compressions with the LUCAS™ device: a multicentre study of victims after unsuccessful resuscitation.Resuscitation. 2014; 85: 1708-1712
- Traumatic injuries after mechanical cardiopulmonary resuscitation (LUCAS™ 2): a forensic autopsy study.Int J Legal Med. 2015; 129: 1035-1042
- Mechanical CPR in refractory cardiac arrest may be practical, but injuries should be monitored: a concise meta-analysis.Resuscitation. 2018; 122: e5-e6
- Characteristics of mechanical CPR-related injuries: a case series.J Forensic Leg Med. 2020; 70101918
- The comparison of cardiopulmonary resuscitation-related trauma: mechanical versus manual chest compressions.Forensic Sci Int. 2021; 323110812
Chun MJ, Zhang Y, Toraih EA, McGrew PR. Iatrogenic injuries in manual and mechanical cardiopulmonary resuscitation [e-pub ahead of print]. Am Surg. https://doi.org/10.1177/00031348211047507
- Safety of mechanical and manual chest compressions in cardiac arrest patients: a systematic review and meta-analysis.Resuscitation. 2021; 169: 124-135
Kahn PA, Dhruva SS, Rhee TG, Ross JS. Use of mechanical cardiopulmonary resuscitation devices for out-of-hospital cardiac arrest, 2010-2016. JAMA network open. 2019;2(10):e1913298.
- Refractory cardiac arrest in a rural area: mechanical chest compression during helicopter transport.Acta Anaesthesiol Scand. 2013; 57: 71-76
- LUCAS compared to manual cardiopulmonary resuscitation is more effective during helicopter rescue—a prospective, randomized, cross-over manikin study.Am J Emerg Med. 2013; 31: 384-389
- The analysis of efficacy for AutoPulse™ system in flying helicopter.Resuscitation. 2013; 84: 1045-1050
- Does a higher ROSC-rate with mechanical CPR lead to better survival in helicopter rescue?.Resuscitation. 2014; 85: e13
- Benefit of mechanical chest compression devices in mountain HEMS: lessons learned from 1 year of experience and evaluation.Air Med J. 2014; 33: 299-301
- Termination of cardiopulmonary resuscitation in mountain rescue.High Alt Med Biol. 2012; 13: 200-208
- Full recovery after prolonged cardiac arrest and resuscitation with mechanical chest compression device during helicopter transportation and percutaneous coronary intervention.J Emerg Med. 2014; 47: 632-634
- Mechanical chest compression: an alternative in helicopter emergency medical services?.Int Emerg Med. 2015; 10: 715-720
- LUCAS™ 2 in Danish search and rescue helicopters.Air Med J. 2016; 35: 79-83
- Mechanical LUCAS resuscitation is effective, reduces physical workload and improves mental performance of helicopter teams.Minerva Anestesiol. 2016; 82: 429-437
- Implementation of a mechanical CPR device in a physician staffed HEMS–a prospective observational study.Scand J Trauma Resusc Emerg Med. 2018; 26: 1-5
- Hypothermic cardiac arrest with full neurologic recovery after approximately nine hours of cardiopulmonary resuscitation: management and possible complications.Ann Emerg Med. 2019; 73: 52-57
- Mechanical chest compression devices in the helicopter emergency medical service in Switzerland.Scand J Trauma Resusc Emerg Med. 2020; 28: 1-9
- Equipoise and the ethics of randomization.J R Soc Med. 1995; 88: 552
Article info
Publication history
Published online: August 16, 2022
Identification
Copyright
© 2022 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.
