Emergency Medical Services (EMS) personnel implement a broad spectrum of approaches to out-of-hospital cardiac arrest, among which compression-assist devices may be the most effective, according to study results intended to be presented at the 2020 American College of Cardiology (ACC.20).
Researchers sought to examine the use of cardiopulmonary resuscitation- (CPR) assist devices by EMS personnel in individuals experiencing out-of-hospital cardiac arrest. They collected data from the National Emergency Medical Services Information System (NEMSIS) Database on EMS calls that took place between January 2017 and September 2019 to determine whether a CPR assist device was used and the nature of the outcome.
In total, 257,341 EMS encounters met the inclusion criteria. Return of spontaneous circulation was achieved in 26% of cases. Assist device use was uncommon: plunger-type devices and Band or Thumper devices were used in 11% and 3%, respectively of patients experiencing cardiac arrest.
Plunger and Thumper devices had a 33% rate of Return of spontaneous circulation was achieved in a comparable percentage of patients on which Plunger or Thumper devices were used (33% for each). External band devices were associated with return of spontaneous circulation in 29% of patients. Ventilation with an impedance threshold device and mouth to mask ventilation were associated with return of spontaneous circulation in 33% and 31% of cases, respectively.
“The NEMSIS database shows a broad spectrum of approaches to [out-of-hospital cardiac arrest]. Compression-assist devices are thought to increase the likelihood of [return of spontaneous circulation], yet their use remains low,” concluded the researchers.
“Further studies should examine these different approaches and specific high-performing systems to continually optimize the care of critical patients.”
Shekhar A, Mercer C, Ball R. Pre-hospital use of CPR-assist devices and return of spontaneous circulation: Nationwide experience from the NEMSIS Database. Intended to be presented at: American College of Cardiology 69th Annual Scientific Session. March 28-30, 2020; Chicago, IL. Presentation 905-04.