After cancer and heart disease, cardiac arrest is the third leading cause of death in the US. Around 6% of out-of-hospital cardiac arrest (OHCA) victims survive – a low percentage indicating how much immediate reaction is important for improving the survival rate.
According to the CDC, about 7 out of 10 cardiac arrest cases occur at home, where help usually comes later. This still leaves 3 out of 10 cases in public places, in which the victim relies solely on bystanders’ help. Regardless of where they happen, each of these cases asks for high-quality CPR techniques for good physical and neurological outcomes.
First responders and paramedics are certified in CPR, and even though they always do everything in their power to help the victim, one slight error can have dire consequences. This is where mCPR, or mechanical cardiopulmonary resuscitation appliances, can be crucial.
Delivering pre-hospital care, mCPR devices offer on-point automated CPR methods. Keep reading to learn more about the different types of mCPR devices and how each works.
What Is an mCPR Device?
Mechanical cardiopulmonary resuscitation (mCPR) is a method used to provide chest compressions to a person who has suffered a cardiac arrest. The mCPR is a medical device that helps maintain oxygen-rich blood circulation to the body and brain. The mCPR involves using a mechanical appliance to deliver rhythmic chest compressions that are more profound and congruous than manual CPR.
When laypeople give manual CPR, errors can happen since it is a stressful situation for the giver of the life-saving technique. After a while, the giver of CPR may even feel exhausted due to providing non-stop chest compressions. However, when an mCPR is used, there is no room for human errors or fatigue. This new technology offers continuing and ultra-quality CPR.
First responders, paramedics, and other medical personnel apply mCPR devices to supplement manual CPR for more precision and better chances of survival, especially if the victim’s already been receiving CPR for a while.
Short Overview of the mCPR Timeline
The first mention of external chest compressions was recorded in a research paper back in 1908. Over the years, this idea was developed by Harkins and Bramson, who came up with a technological innovation: an electrical device that worked on compressed gas featuring a piston with a force of 60 and 75 pounds. It was created specifically to fit over a typical hospital stretcher. The inventors believed it could change the outcomes in cardiac arrest patients.
With time, new innovations in the mCPR sector arose, and there were a lot of different mCPR appliances. In the 1960s, there were several innovations in mCPR, like a remote pneumatic pump, a portable battery-powered device, a mechanism that was powered by an oxygen cylinder, a CPR vest, and others.
In modern medicine, all previous mechanisms are incorporated in a specialized apparatus that resembles the vest CPR but in an upgraded version. The newest mCPR devices deliver quality CPR and greatly help first responders and paramedics, especially during transport, providing oxygenation to the patient’s body in a pre-hospital scenario.
Types of mCPR Devices
Expert personnel use two types of mCPR appliances – piston-based vs. vest-based devices. The two types’ purpose is the same – providing automated compressions at a specific rate and depth – but their usage is distinct:
The piston-based devices utilize compressed air or are powered by electricity. The personnel will place a specialized backboard under the patient, to which the device is affixed. The piston comes right over the sternum, compressing the patient’s chest in a way that ensures full recoil.
Vest-based devices are similar to piston-based ones but use a different approach. The vest-based device has an air-filled vest. These devices are powered by a battery to which an electrical motor is connected.
The electric motor pulls a stretching band, which applies automated chest compressions over the patient’s chest. Additionally, a backboard is placed under the patient’s thorax.
How to Use a Vest-based vs. Piston-based mCPR Device
First responders and other medical personnel should be trained and accredited to use an mCPR device. We will try to explain a simple usage of the two types of devices. It is not as simple as AED usage and defibrillation, but every mCPR device has a manual inside the package that can help if a situation arises.
Here is a short guide on how to use a vest-based mCPR device correctly:
- Put the vest-based mCPR device on the patient’s chest. Ensure that the device is centered and stable. Also, check if the straps are adequately set.
- Find a power source and connect the device.
- Set a customized mode on the device that fits the patient’s needs. When setting the mode, adjust the duration, intensity, and level to correspond with the patient’s situation.
- When the specific mode is set, click on the device to start it.
- Observe the patient’s progress and tailor the device to the patient’s needs.
- Once you notice improvement, turn off the device and plug it out from the power source.
- Take off the device from the patient and secure it in a safe place.
Simple guidelines on how to use a piston-based mCRP device:
- Make sure the stabilization strap is in order.
- Connect the mCPR device to a power source.
- Ensure that the suction cup is placed correctly.
- Place the device under the patient so that the backboard is underneath the patient’s chest.
- Assemble the upper part of the back plate.
- Make sure the suction cut is above the person’s sternum and adjust the position and height of the cup.
- Press the cup to the person’s sternum without pushing it too hard.
- Turn on the device and adjust the controls to fit the patient’s needs.
- Secure the person’s hands.
- Monitor the patient and make amends on the mode to fit the patient’s state.
- Turn off the device when the session ends, remove it from the patient, and store it properly.
Outcomes of mCPR Usage in Hospital Scenarios
Studies have found that mechanical CPR devices can enhance resuscitation outcomes in cardiac arrest patients already in the hospital. The studies show that the return of regular circulation rate was 83% in patients that received CPR with a mechanical device, compared to a 48.8% in patients that were given manual CPR. The survival rate before discharge was higher in patients who received mechanical resuscitation than in those who received manual CPR.
Outcomes of mCPR Usage in Out-of-Hospital Scenarios
Studies researching the use of mechanical CPR during out-of-hospital cardiac arrest have had inconsistent results. However, what we know is that mechanical CPR helps in out-of-hospital settings, especially during transport.
Multiple mCPR devices have been associated with the return of circulation and survival to hospital discharge. However, the brand and the general ins and outs of each device can make a significant difference.
Benefits and Disadvantages of mCPR Devices
The old-fashioned manual CPR is still considered the best option for out-of-hospital situations, but using mCPR devices, especially in transport, can have many benefits. Let’s go over the possible benefits and disadvantages of using mCPR devices:
Benefits of Using mCPR Devices:
- Consistent, high-quality compressions
- Saviors in situations where there is a shortage of staff, or the staff are exhausted.
- The medical staff can proceed to apply defibrillation safely
- Elimination of interruptions while applying compressions
- Ensured performance of chest compressions in confined spaces
- Medical personnel can focus on taking care of other injuries
- Decreased risks of physical injuries.
Disadvantages of using mCPR devices:
- Studies have not proven their superiority over manual CPR
- Staff must be trained and certified to know every detail of the usage and maintenance of the device
- Availability issues
- Equipment and power sources can malfunction and have interruptions in compressions
- Can cause trauma in patients
- Devices for adults are not compatible with children
- The devices are adjustable but cannot fit every body type.
Conclusion: What Is an mCPR and Do They Work?
Evidence from case studies shows mechanical CPR can enhance resuscitation outcomes in certain situations, especially in situations calling for emergency response.
Many research papers show that combining mCPR devices and manual CPR significantly improves victims’ survival outcomes. Also, it helps medical personnel take care of other injuries or traumas and deliver safe defibrillation to the victim.
However, further research is required to determine the optimal use of mCPR devices in different situations. For now, it’s best to provide manual CPR first and only employ mCPR devices in special cases.