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LUCAS 2 Compression Device

LUCAS 2 Compression Device . Medicare EMS Ltd. Objectives . Explain in importance of Coronary Perfusion Pressure Visit why quality CPR matters Introduction of the LUCAS 2. Coronary Perfusion Pressure (CPP).

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LUCAS 2 Compression Device

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  1. LUCAS 2 Compression Device Medicare EMS Ltd

  2. Objectives • Explain in importance of Coronary Perfusion Pressure • Visit why quality CPR matters • Introduction of the LUCAS 2

  3. Coronary Perfusion Pressure (CPP) • The coronary perfusion pressure is the difference between the aortic diastolic pressure and left ventricular end-diastolic pressure (LVEDP) • Normal values in normal coronary artery flow (TIMI III) is said to be between 15 – 70mmHg • CCP in cardiac arrest has been shown to need to be above 15mmHg for ROSC • Every interruption to compressions leads to a drastic fall in CCP that takes time to rebuild

  4. Resus Council Guidance • 30 compressions to 2 ventilations • Compression rate 100-120 per minute • Depth of at least 2inces/5cm • Chest must be allowed to fully recoil • Minimise interruptions • Change every 2 minutes

  5. Quality CPR • Ultimately provides blood to the brain and heart • Generates Coronary Perfusion Pressure • Return of spontaneous circulation is thought to associated with a CPP of 15mmHg or above

  6. Quality CPR • Large number of studies have shown that quality CPR is essential to achieve high CPP and successful defibrillation • As soon as CPR is stopped the CCP falls dramatically and takes up to 90 seconds to resume – rationale for changing from 15:2 to 30:2 • Introduction of mechanical devices may solve this

  7. Fatigue • Ideally rotate every cycle/2 minutes • Fatigue will lead to poor quality compressions in rate and depth • Significant fatigue and shallow compressions have be shown after 1 minute

  8. LUCAS 2 • LUCAS2 is a mechanical compression device that has several benefits for the cardiac arrest patient; • Increased blood flow to the brain from 40% in normal CPR to 65% • Maintaining CCP of 15mmHg • Increase ETCO2 • Reduction to compressions interruptions • Defibrillation during compressions

  9. LUCAS 2 Uses: • Adult patient in cardiac arrest • Must only be used for chest compressions ie not for external pacing Contraindications: • Not possible to safely attach device • Patient too small/big

  10. Control Panel On/Off Adjust Pause Active – continuous Active – 30:2 Mute Battery life Alarm indicator

  11. Activating the LUCAS 2 • Push the On/Off button for 1 second to start self test • The LED (green) light will illuminate when the LUCAS is ready for use

  12. Assembly • Remove the back plate • Stop CPR and place back plat under patient below the arm pits • Start CPR

  13. Assembly • Once LUCAS has been removed from its bag pull release rings to ensure claw locks are open • Straddle the patient • Attach one of the supporting legs to the back plate • Stop CPR • Attach the second supporting leg to the back plate

  14. Adjustment • Ensure the LUCAS in is adjust mode • Push the suction cup down with two fingers until the pressure pad is touching the patients chest – ensure no restriction the chest wall • Push the Pause button to lock the device in the start position (if the patient is too small for the device the warning alarm will sound resume CPR) • It should take no more than 20 second to attach the device to the back plate – get practicing!!!

  15. Activation • Check the suction cup is in the correct position. If not: • Push the Adjust button again and reposition • Push the Active button – either continuous or 30:2 • Pressing Pause at any time will stop the device but it will still remember the start position • Apply the stabilisation straps – back of the neck the device and the wrists to the device

  16. Defibrillation • Defibrillation can be performed whilst the device is active • The pads can be applied before or after the device – they should already be on the patient! • Ensure no wires or pads are trapped by the device • After defibrillation ensure the device is still in the correct position, adjust if necessary • The LUCAS need only be stopped for an ECG – the device should not be required if this is required!

  17. Ventilation • OP, NP, LMA or igel– operate the device in 30:2 mode • Deliver ventilations as per guidelines during the paused phase • ET – operate in continuous mode • The green LED light will illuminate 8 times per minute to indicate ventilation required

  18. Transporting • Remove the patient using available equipment as normal • Pause the device when rolling the patient • The device can be activated again when removing the patient • The device will stay in place even if the patient is tilted on a slight angle

  19. Battery • Remove the spare battery • Push the Pause button • Pull the battery upwards to remove • Slot in the new battery • Wait until the pause LED light to illuminate • Push active to start the compressions again • The device will remember the start position for 60 seconds

  20. Cleaning the Device • Remove the contaminate suction cup • Do not immerse the device in water • Clean as per universal precautions • Ensure device is dry before repacking • Mount new suction cup by pulling over compressor

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