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Observational Study
. 2020 Jul 25;28(1):71.
doi: 10.1186/s13049-020-00758-1.

Mechanical chest compression devices in the helicopter emergency medical service in Switzerland

Urs Pietsch  1   2 , David Reiser  3 , Volker Wenzel  4 , Jürgen Knapp  5   3 , Mario Tissi  6 , Lorenz Theiler  3   6 , Simon Rauch  7   8 , Lorenz Meuli  9 , Roland Albrecht  10   6
Affiliations
Observational Study

Mechanical chest compression devices in the helicopter emergency medical service in Switzerland

Urs Pietsch et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: Over the past years, several emergency medical service providers have introduced mechanical chest compression devices (MCDs) in their protocols for cardiopulmonary resuscitation (CPR). Especially in helicopter emergency medical systems (HEMS), which have limitations regarding loading weight and space and typically operate in rural and remote areas, whether MCDs have benefits for patients is still unknown. The aim of this study was to evaluate the use of MCDs in a large Swiss HEMS system.

Materials and methods: We conducted a retrospective observational study of all HEMS missions of Swiss Air rescue Rega between January 2014 and June 2016 with the use of an MCD (Autopulse®). Details of MCD use and patient outcome are reported from the medical operation journals and the hospitals' discharge letters.

Results: MCDs were used in 626 HEMS missions, and 590 patients (94%) could be included. 478 (81%) were primary missions and 112 (19%) were interhospital transfers. Forty-nine of the patients in primary missions were loaded under ongoing CPR with MCDs. Of the patients loaded after return of spontaneous circulation (ROSC), 20 (7%) experienced a second CA during the flight. In interhospital transfers, 102 (91%) only needed standby use of the MCD. Five (5%) patients were loaded into the helicopter with ongoing CPR. Five (5%) patients went into CA during flight and the MCD had to be activated. A shockable cardiac arrhythmia was the only factor significantly associated with better survival in resuscitation missions using MCD (OR 0.176, 95% confidence interval 0.084 to 0.372, p < 0.001).

Conclusion: We conclude that equipping HEMS with MCDs may be beneficial, with non-trauma patients potentially benefitting more than trauma patients.

Keywords: AutoPulse; Cardiopulmonary arrest; Cardiopulmonary resuscitation; Helicopter emergency medical services; Load-distributing band CPR device; Mechanical chest compression devices.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
Flow Diagram of Scene Calls of Primary and Secondary Missions
Fig. 2
Fig. 2
Univariate compared to Multivariate Logistic Regression Models on Survival in Resuscitations using MCD. Figure based on the Complete-Case Analysis, see Tables 4 and 5. exp. (Estimate): Representing odds ratios, 1.00 indicates no difference in survival. The line around the dot indicates the 95% Confidence interval of the odds rat
See this image and copyright information in PMC

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