Lucas Device

[emt11]

What do you think about them? We carry them on our trucks and I personally have not noticed a huge help(other than the obvious non fatigue) and have noticed it is becoming an item that is starting to be left on the trucks where I work for cardiac arrest calls and placed on the patient when we load the patient and start for the hospital(yes we still transport asystole L&S).


http://millhillavecommand.blogspot.com/2014/03/we-had-lucas-save-no-you-didnt.html

What are your thoughts on the above?

 

[NomadicMedic]

Standard of care here. We use them on every arrest, unless the patient doesn't fit. Anecdotally, they're excellent at providing uninterrupted compressions.

 

[emt11]

Standard of care here. We as them on every arrest, unless the patient doesn't fit. Anecdotally, they're excellent at providing uninterrupted compressions.

Were required to use them by CQI unless they dont fit the patient.

 

[PotatoMedic]

Never seen one used or on a truck. Granted this is King county so we get everyone, their mother, and the kitchen sink at a CPR. I would love to see one used.

 

[teedubbyaw]

Why wouldn't you use them? They give exacted compressions every time and free up providers.

 

[PotatoMedic]

Well if you looked at the report it showed no difference in outcomes. I personally would love to give one a shot and be trained on how to set it up quickly and use it. I am also in a system where I almost literally get an army if I call a CPR in progress.

 

[emt11]

Well if you looked at the report it showed no difference in outcomes. I personally would love to give one a shot and be trained on how to set it up quickly and use it. I am also in a system where I almost literally get an army if I call a CPR in progress.

Funny thing is, we have the Lucas but we also get an army of people on cardiac arrest calls, including us(private third service) ALS ambulance, 1 BLS engine(4 people), 1 ALS rescue(2 people), so your looking at 8 medical plus a LEO or two.

 

[KellyBracket]

If you guys have any questions about my post, just ask. There is room for an interesting discussion here!

 

[ZombieEMT]

I think these work better in areas where large responses for CPR calls do not exist. It frees up the providers to do other tasks. Even if the outcomes were not any better while using it, they do provide for consistent compression and free up a provider. Sometimes that alone might be worth it.

 

[emt11]

I think these work better in areas where large responses for CPR calls do not exist. It frees up the providers to do other tasks. Even if the outcomes were not any better while using it, they do provide for consistent compression and free up a provider. Sometimes that alone might be worth it.

Though how would a service justify that based on a unit price of $16,500 a piece? Plus the device is about as tall as a LP 15 and slightly longer so it does take up a good portion of space.

 

[chaz90]

Though how would a service justify that based on a unit price of $16,500 a piece? Plus the device is about as tall as a LP 15 and slightly longer so it does take up a good portion of space.

One less thing to worry about during a code. No effort has to be placed into ensuring continuous high quality compressions at a proper rate or switching compressors. Continuous compressions and minimizing perishock pauses are correlated with improved survivability, whether or not those compressions are provided by a highly coordinated team of well trained personnel or a mechanical device. We have chosen to give ourselves the best chance of getting compressions done right the most times, so we use LUCAS 2 devices on all trucks with every code. Not saying this is the only way or the next coming of defibrillation or anything, but it works well for us.

 

[KellyBracket]

At what point in the code are your systems applying the device?

Right at the start, at some point in the first 6-10 minutes, or only after that?

 

[chaz90]

As soon as we arrive on scene. Since it's a tiered system, the BLS ambulance is often there first with manual CPR and AED usage. As we arrive, one medic typically transitions the Combi Pads to our LP15 and does a quick rhythm check as manual CPR continues and the second medic is setting up the LUCAS. After that initial shock (or not), manual compressions continue minus the brief pause to put the LUCAS backboard under and we transition to mechanical compressions. There are two BLS departments in our county that have the LUCAS as well, so those are typically applied by the time ALS gets on scene.

 

[KingCountyMedic]

Seattle Medic One did a trial, used them for a while and found it wasn't for us. IF there had been a big difference we would have ended up putting them out in the rest of King County. We do have a large response for CPR calls and we do good with humans doing our compressions. I can see where it might be good for others. It prob does a better job than manual CPR on the road, but we almost never transport ongoing CPR.

 

[mycrofft]

When these devices came out originally, they got a reputation for shifting the axis of compression (e.g., they didn't stay in place…E.G. again, they slipped around).

The posited perfect code was 100 oxygen via automatic ventilator on an endotracheal tube, a Thumper, and a Physiocontrol Lifepak (trademark) machine with automatic "shock on T" software (which also got a bum rap as not doing it on "T").

It seems to stand to reason they are a good deal, but why aren't they clearly superior?

One thing I think which makes it harder to quantify, despite the apparently excellent study parameters, is that the majority of people needing CPR are not going to survive. Asystole is a symptom, not a malady, and it occurs in people of varying ages and etiologies (which they tried to control for) so the outcomes cannot be treated as a "Do this to get that" deal.

Sometimes Magic Max was wrong and "Dead is dead".

 

[KellyBracket]

Seattle Medic One did a trial, used them for a while and found it wasn't for us. ...

That was with the LUCAS, AutoPulse, or "other?"

 

[KingCountyMedic]

That was with the LUCAS, AutoPulse, or "other?"

I'm pretty sure it was Lucas, there might have been two different types, I can't remember. It never made it past the Seattle city limits. I've never seen any of them in use in person.