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

Publication

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

Journal Paper/Review - Jul 25, 2020

Pietsch Urs, Reiser David, Wenzel Volker, Knapp Jürgen, Tissi Mario, Theiler Lorenz, Rauch Simon, Meuli Lorenz, Albrecht Roland

Citation

Pietsch U, Reiser D, Wenzel V, Knapp J, Tissi M, Theiler L, Rauch S, Meuli L, Albrecht R. Mechanical chest compression devices in the helicopter emergency medical service in Switzerland. Scand J Trauma Resusc Emerg Med 2020; 28:71.

Type

Journal Paper/Review (English)

Journal

Scand J Trauma Resusc Emerg Med 2020; 28

Publication Date

Jul 25, 2020

Issn Electronic

1757-7241

Brief description/objective

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.