New machine does CPR chest compressions

The whole goal of treating people in cardiac arrest is to get their pulse going again, and that’s something the Gresham Fire Department has had great success in since starting its Cardiac Arrest Management program back in 2007.

The program includes extensive cardiac arrest training for firefighters, all of whom are EMTs and paramedics, as well as using advanced technology, such as the Lucas II chest compression machine the department bought last July.

Since implementing the cardiac arrest program, firefighters have increased the number of patients whose pulse was restored from 23 to 54 percent, said Operations Chief Mark Maunder. The department has two Lucas II machines that were used on 25 people in the past six months; 16 of them had their pulse restored before reaching the hospital, a rate of 64 percent.

The Lucas machines, which cost about $14,000, are used on the department’s busiest units, Maunder said, and are only part of the reason that more Gresham area people are alive when they reach the hospital, but he’d like to have more.

The cardiac arrest program was developed in-house, said Capt. Jay Cross.

“We took the better parts from the incident command system and crew resource management that many, including airlines, use, advanced cardiac life support from the American Medical Association, and our medical protocol, combined with this training program,” Cross said.

The Lucas II machine is useful because it automatically delivers about 100 chest compressions per minute, which is optimal for people in cardiac arrest. A human tires out after about two minutes, Cross said, and has to have someone else take over, and it’s particularly awkward to do chest compressions in the back of a moving ambulance.

“Probably the biggest danger we have is riding in the back of a Code 3 ambulance standing over a patient doing compressions,” he said. Once, when a driver hit the brakes, Cross was thrown into the front seat, but he got back up and continued to work on the patient.

The department is constantly looking for ways to improve service to people in distress, Maunder said. Of utmost importance is that they are able to respond within four to six minutes.

“For all of our responsibilities, it boils down to a question of response times,” he said.

That’s more difficult every day as demand for ambulance service increases, he said. The Gresham Fire Department covers surrounding towns as well, providing emergency medical service to about 150,000 people. One new development is the ability to transmit EKG results to a hospital while the ambulance is en route, so the hospital “knows what’s going on with the patient’s heart before we arrive,” Cross said.

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