The LUCAS device can provide effective and uninterrupted compressions during the entire EMS scene and transport experience. This is the reality of prehospital care that cannot be nicely quantified, and this is why proof of equivalency in neurologic outcomes between manual and mechanical CPR is so important. None of these situations lend towards effective compressions, and some are even dangerous to providers. Imagine standing up unrestrained in a moving ambulance driving lights and sirens through traffic to perform compressions on a patient. Imagine performing compressions in an elevator on an upright patient because there is not enough room to lay the patient flat. Imagine performing compression in a stairwell, stopping on each landing to “catch-up” compressions since you can’t carry the person and do compressions simultaneously. During transport, however, is where the benefit of mechanical CPR truly emerges. On scene, a mechanical CPR device can free up a provider to perform other tasks. Many of these resuscitations are pronounced in the field, but not all. Eventually backup arrives, which may only be another pair of providers. Maybe they have upset or angry bystanders to control as well. This is after they just carried their equipment up six flights of stairs. In a six-story walkup apartment, the situation is different: the initial team consists of two people, one of which needs to gather information, ventilate, obtain access, and give medications while the other does compressions. In the hospital, the patient generally remains on a gurney with adequate staff to rotate every two minutes per the AHA standards. Manual CPR performance in the field creates unique challenges for EMTs and paramedics.
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