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Philips in CPR. Philips Resuscitation Technology Solutions. Our goal is to relate Philips in CPR directly to the 2005 AHA guidelines Quick Shock SMART CPR Q-CPR TM. Quick Shock Only from Philips. AHA Guidelines 2005.
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Philips Resuscitation Technology Solutions • Our goal is to relate Philips in CPR directly to the 2005 AHA guidelines • Quick Shock • SMART CPR • Q-CPRTM
Quick Shock Only from Philips
AHA Guidelines 2005 • Effective chest compressions are essential for providing blood flow during CPR • Blood flow delivers small but critical amount of oxygen to brain and myocardium • CPR increases the likelihood that a shock will be successful (i.e. will terminate VF and the heart will resume an effective rhythm and perfusion) • When shock is indicated, it is critical it be delivered as soon as possible after chest compressions are stopped • Reduction in interval between compressions and shock delivery by as little as 15 seconds can increase predicted shock success
What is Quick Shock? • Ability to deliver a shock in less than 10 seconds after CPR pause • Unique feature offered only on Philips AEDs • Available on all HeartStart OnSite, FRx and FR2+ AEDs • Competitive devices take between 13 and 27 seconds to deliver a shock
80% 60% 40% 20% Survival Linked to Speed of Shock Delivery After CPR Times measured from end of Stop-CPR prompt, with AEDs at maximum energy Survival 100% 0% 25 30 10 0 5 20 15 Time to shock in seconds after CPR is stopped HeartStart HS1 & FRx 8.1s & 8.4s HeartStart FR2+ Survival data: Swine; 7 minutes of VF Yu T, et al. Circulation. 2002; 106:368-372 9.98s
Defibtech Lifeline Medtronic CR+ & Welch Allyn AED20 HeartStart FR2+ 9.98s Times measured from end of Stop-CPR prompt, with AEDs at maximum energy Survival Linked to Speed of Shock Delivery After CPR Survival 100% 80% 60% 40% 20% 0% 25 30 10 0 5 20 15 Time to shock Medtronic CR+ Medtronic LP500 in seconds after CPR is stopped Auto HeartStart HS1 & FRx 8.1s & 8.4s Cardiac Science G3 Auto Welch Allyn AED10 Survival data: Swine; 7 minutes of VF Yu T, et al. Circulation. 2002; 106:368-372 Cardiac Science G3 & Zoll AED+
Why is Quick Shock Important? • Relates directly back to the guidelines; a reduction in interval between end of compressions and shock delivery can increase predicted shock success • Using Philips AEDs with Quick Shock, the chance of survival is 80% or higher • In 8 out of 9 competitive AEDs, survival rate is 40% or lower
SMART CPR Only from Philips
AHA Guidelines 2005 • Recommend EMS providers consider CPR before shock for un-witnessed events, particularly when arrival time is > 4-5 minutes • When EMS call-to-arrival time > 4-5 minutes, victims who receive 1½ – 2 minutes CPR before defibrillation showed increased survival rates compared with those who received immediate defibrillation: • An increase in survival due to initial resuscitation • An increase in survival-to-hospital discharge • An increase in 1 year survival rate
Defibrillating VF Doesn’t Always Restore Circulation • A patient with a coarse, spiky rhythm typical of short-duration VF may still have an energetic heart & may benefit from an immediate shock • A patient with a weaker, flatter rhythm typical of long-duration VF has a depleted heart and is unlikely to return to circulation with a shock • Other contributors besides VF duration: Diseased heart, cause of arrest • CPR first showed improved survival rates
What is SMART CPR? • Technology that analyzes the patient’s rhythm for you and determines whether to shock first or perform CPR first • Reinforces Guidelines 2005 recommendation of CPR before shock for un-witnessed events, particularly when arrival time is > 4-5 minutes • Takes the guesswork out of determining length of victim downtime especially for un-witnessed events • Available only on the Philips HeartStart FR2+
CPR first Shock first (traditional AED behavior) Why is SMART CPR Important?The Survival Curve At 4+ minutes of downtime, chance of survival decreases with traditional shock first therapy 50 40 30 20 10 0 Probability Of Survival (%) 0 1 2 3 4 5 6 7 8 9 10 Ambulance Response Time (Minutes) Wik, et al. JAMA, 2003, 289;1389-1395
AHA Guidelines 2005 • Methods needed to improve quality of CPR • Increased emphasis on importance of chest compressions - “push hard, push fast” • Components of quality CPR include ventilation rate & duration, compression depth, compression rate & number, complete chest recoil, and hands-off time • Hyperventilation, including too many breaths or too large a volume, diminishes cardiac output and survival
What is Q-CPR? • Q-CPR is the first and only CPR measurement and feedback tool integrated into an ALS monitor/defibrillator • Q-CPR promotes high-quality CPR delivery
Why is Q-CPR Important? • Q-CPR measures the exact items specified by the AHA Guidelines • Compressions: • Compression depth • Compression rate • Leaning (incomplete release) • Duty cycle (duration ) • No flow time (inactivity timer) • Ventilations: • Volume low • Frequency high or low • Inflation time fast or slow
Philips Resuscitation Technology Solutions… Leading the Way • Quick Shock on all HeartStart AEDs • SMART CPR for trained first responders • Q-CPR; CPR Measurement and Feedback for ALS professionals