Currently, the states producing the most CPR survival rate (discharge from the hospital) are Washington State and Texas, although each state will profess that their rate is higher. Nonetheless, their success comes from a population who show interest by stepping forward to assist a person who is down. Additionally, EMS training throughout the country has demonstrated that education does work and plays an important part on whether a person decides to help or not. Moreover, touching or giving mouth to mouth on a victim who is clinically dead is increasingly showing a decreased interest because of the contagious diseases that have been highlighted affectionately throughout the media. They include herpes, AIDS, tuberculosis, measles, E.coli and more. So what have science done to put the layperson at ease?
The answer is CPR devices for the healthcare provider and absent ventilations for the layperson. CPR devices have proven to be effective if they are used appropriately and the absence of ventilations during CPR has been coming for some time. According to the American Heart Association, complete recoil after adequate compression of the chest and repeating this step causes oxygenated blood flow to the brain. This relieves the layperson from placing their mouth on the mouth of the victim in cardiac arrest. The CPR devices that are currently on the market have proven to be effective based on the size of the patient and how well trained the crew is in deploying it.
Devices that are used hands-free are mechanical and permit the crew to treat the patient with advanced level medication and skills plus the crew is not exhausted from prolonged manual resuscitation. The devices include 1) the Lund University Cardiac Arrest System Device (LUCAS), Vest CPR, Autopulse, Bag Valve Mask (BVM), Pocket Mask, the new CPR RSQ Assist (A device that helps make hands only CPR easier), CPR Microshield and the Metronome. As time proceeds into the next generation, scientists, field personnel, and ordinary people will produce more assist devices for cardiopulmonary resuscitation.
Even though research has been done, each company will represent that their device is the best on the market. However, the real test comes from the actual use from the crews of fire engines and paramedic ambulances and how comfortable they are when they apply the device. It has been known that the Autopulse (which appears to be an extension of the Vest CPR) has had a tendency to be placed lower than its purpose and this is based on perhaps overzealous caregivers who may not be attentive to the placement. The Lucas Device has been known to use a lot of battery power.
Ultimately, the use of each device depends on how well the crew is trained. Furthermore these devices may not be proper for patients with artificial hearts, such as the Left Ventricular Assist Device (LVAD), Phoenix-7, Abiomed, Berlin Heart, MagScrew, PolVad, and others. To use a mechanical device has been proven to be detrimental in some cases where damage to the artificial hearts was unrepairable. In addition, the latter artificial hearts are prototypes. Likewise, the victim with an LVAD does not have a pulse. Therefore if this victim appears to be sleep while sitting on an airplane, bystanders may tend to think that he is in cardiac arrest, especially if they attempt to take his pulse. What is the most appropriate action to take in this situation?
Certainly, cardiopulmonary resuscitation will be the first step. However, the most effective treatment for this type of patient is to change his or her battery which re-engages the motor on the LVAD and consequently, the patient wakes up. Hence, the simplest CPR device to use is critical thinking by re-engaging the motor.
In other cases where laypersons have found victims unconscious and pulseless, on the ground and have a strong urge to provide ventilations along with chest compressions, a simple pocket mask device can be used. However, mouth-to-mouth is not completely disregarded; especially if the victim is a family member.
Finally, cardiopulmonary resuscitation is a lifesaving tool that every human being should know how to do. If done properly, it can save your life. If done improperly, it still may save your life because doing something is better than doing nothing. Additionally, the American Heart Association understands the anxiety that laypersons may have when rendering care to a patient in cardiac arrest. Therefore the company has allowed for hands only CPR with assisted devices that can be used with no skin to skin contact. What’s more, being discharged from the hospital is the ultimate goal of CPR and using assist devices. Eventually every state of the union will be will have bragging rights on the number of lives saved by laypersons.