Automated CPR machine gets to the heart of survival

Published 12:10 am Thursday, February 23, 2023

From very young ages, nearly all of us hear about CPR, and maybe even CPR training — learning how to keep someone’s heart beating after they have a heart attack or other cardiac event that causes the heart to stop. And by the time any of us become teenage pool lifeguards over the summers, CPR training is part of that job training.

Through the years, medical science has refined what is known about heart attacks and the best way to keep someone alive until medical help arrives. Once upon a time, the training involved chest compressions rotated with breathing air into the lungs. But there were sometimes complications. The nose had to be closed, the seal of mouth to mouth secure to make sure the air was getting in, and the airway itself needed to be clear. Placement of the hands on the chest needed to be in the correct spot to be effective and many times ribs were broken in the process.

For many, healing from broken ribs was a small price to pay for surviving. For others, the idea of placing one’s mouth directly over another could be an obstacle. But people often did what was necessary in order to keep another human being alive.

As it turns out, the chest compressions are the most important part, and in CPR training, that is now the focus. Continual chest compressions, not stopping for longer than 10 seconds, despite the fact that studies show the exertion is so intense that a person begins to tire from the efforts after two minutes.

And there is still the problem of possibly breaking ribs, and knowing just how hard to press, or how fast.

But today, a new hero has burst on the scene, and it is not human. There are automatic CPR compression machines, and Rowan County Emergency Services has acquired 15 of them — one for each truck throughout the county.

Chase Prezioso of Zoll, the company that manufactures the machines that Rowan purchased, said each machine is tied in to the computer in the truck it is in, and all data will be captured electronically. In addition, he explained that the band that provides the chest compressions “measures the density of the patient’s chest, so no more broken ribs.” In fact in some demonstrations, he places a paint ball under the band to show that the pressure is just right, but not so hard that the ball would break.

Rowan Emergency Services Battalion Chief Chris Lambert explained that not only is it a benefit because it perfects the measurement and the determination of the strength of compressions, but it helps with manpower.

“When you have a CPR call, you need two to three people just to perform CPR, because after two minutes, you need to swap out,” he said. In fact, it takes a minimum of seven first responders to effectively manage a CPR call. But not needing to swap out personnel every two minutes is a tremendous benefit.

Battalion Chief of Training for Emergency Services Bradley Dean gathered those who attended Tuesday’s introduction and training session to go over some basic knowledge of how calls are handled before showing how the machine operates. He pointed out that before COVID hit, the county had raised its numbers of survival with no neurological impact on CPR calls to nearly 43 percent, closing in on the goal of 50 percent. But COVID, and the need to stage all calls and put on additional protective equipment, sent the number spiraling down to 13 percent. Now, however, the survival percentage numbers have climbed back to 33 percent, and by 2024, Dean has high hopes of hitting the 50 percent mark.

He said even before these automated CPR machines, the focus had shifted to quality compressions, hands on the chest, without worrying about resuscitation or airways. Just keep the heart beating, and do not break the compressions for more than 10 seconds. The ability to shock the heart, using a defibrillator, is another tool that raised survival rates, and now, combining the defibrillator with the automated CPR machine should send survival rates higher still.

On a side note, Dean pointed out that while many of the suggested sites for placement of older AEDs or defibrillators are good, the best, according to studies, are in the personal vehicles of first responders, because many answer calls in their own vehicles, and if they are the first on scene, that AED can be the difference between survival and not.

Emergency Services Chief Allen Cress was at Tuesday’s training session at Rockwell Rural Fire Department, and his pride in Rowan’s participation in a seven-year study with Duke Clinical Research Institute. He said the county is holding a number of the training sessions throughout the county, and Tuesday night, representatives from Gold Hill, Faith, Granite Quarry, Union, Ellis, Rockwell, Rockwell Rural, Liberty, Pooletown and Miller’s Ferry were on hand to check out the new equipment. Each unit cost $15,000 and Cress said thankfully the county approved all the funding.

“We were fortunate enough to be allotted enough money from the county commissioners to be able to get this equipment, and with it we hope to be able to save more lives, and for people that have sudden cardiac arrests, to allow them to go back home to their families,” said Cress. “We have studies we are participating in, and we are hoping also to return to some pre-COVID levels of saving people.”

He deferred to Dean to explain how Rowan County became one of 50 counties in the study.

“They have 50 counties in the project, and there are intervention counties and control counties, determined randomly,” said Dean. “We are one of the intervention counties, so we’re doing the community interventions and filing reports. The reason it’s over seven years is so we can track, measure, prove, track, measure, prove and continue that process.

“I think it’s great for us to be a part of this group,” he added. “We’re working very closely with Cabarrus County, and they are working with us, and Davidson County, because all three of us are part of the intervention counties, as is Forsyth County. We honestly believe among the four of us, we think we will have the largest number 0f patients in the intervention arm of the study.”

The equipment is new enough that not everyone in the medical field knows what it is, according to Emergency Medical Services Division Chief Bryan Edwards.

“We get to the hospital and they look at us like ‘what is that?'” he said.

As of Tuesday night, the automated CPR machine had been used on at least two calls, both successful.