CPR aid devices improve survival rate for Ann Arbor area cardiac patients, study finds
Two CPR devices tested in Washtenaw and Livingston counties increased survival rates for cardiac arrest patients, according to the results of a clinical trial led locally by a St. Joseph Mercy Hospital Ann Arbor doctor.
"More people survived, and more people survived neurologically intact,” when the devices, a hand-held pump and a mouthpiece that controls the flow of air to the lungs, were used during chest compressions, said Robert Domeier, the EMS medical director for the Washtenaw/Livingston Medical Control Authority and an emergency doctor at St. Joseph Ann Arbor.
Domeier, who ran the study locally, said the 5.8 percent survival rate of all cardiac arrest patients in the two-county group increased to 8.9 percent with the use of the devices.
Cardiac arrest is different from a heart attack, in that the heart stops during an arrest. During a heart attack, a blockage cuts off the supply of blood to the heart, though the heart keeps beating.
In all, the study tracked survival rates for 840 individuals who were administered CPR with the devices, and 813 who were administered standard CPR, at seven sites around the country between 2005 and 2010. Six hundred study participants came from Washtenaw and Livingston counties. The manufacturer of the devices funded the study along with the National Institutes of Health. The results were published this month online in The Lancet medical journal.
The device called a ResQPump is suction-cup tool placed where the hands would be during CPR. It enhances the recoiling of the sternum, creating negative pressure inside the chest that gets the blood flowing. The mouthpiece called the ResQPOD prevents unnecessary respiratory gases from entering the chest during the compression process. The devices aim to work together to increase blood flow during CPR, Domeier said.
In October 2010, the American Heart Association revised its CPR guidelines to emphasize the importance of maintaining circulation. It previously taught the A-B-C’s of cardiopulmonary resuscitation — airway, breathing and compressions. But it now recommends C-A-B — compressions, airway, breathing — as the standard for both bystanders and professional rescuers treating cardiac arrest victims.
Dispatch services in Washtenaw and Livingston counties use standardized emergency medical dispatch instructions to describe how to do CPR to bystanders during 911 calls, Domeier said. Those instructions will be changed given the heart association's new guidelines.
“We’re going to be changing the emphasis from doing compressions and ventilations to just doing compressions,” he said. “For the bystanders, for the first couple of minutes until the EMS gets there, it’s less complicated than trying to breathe for the patient and it gets the emphasis in the right place, and the right place is getting the blood moving.”
The ResQPump is not currently approved by the FDA for use in the U.S., though it's used in other countries. The company that funded the study is seeking FDA approval.
“Once that happens, we would see about implementing the device here because we were so impressed with the improvement in survival,” Domeier said.