Last April, the Key Peninsula Fire Department was among the first in Pierce County to obtain a new mechanical compression device to automatically deliver potentially life-saving CPR. One of several devices currently on the market, Autopulse is designed to improve reliable delivery of CPR in the field and in hospital settings.
“We were very impressed with how well defibrillators can work in tandem with the new mechanical compression devices on the market, enabling the paramedic to tend the patient uninterrupted without requiring a second set of hands,” said medical service officer and Battalion Chief Bill Sawaya.
Up to now, the standard protocol for cardiac arrest has been manual compression. “If a person goes down unconscious, has no pulse or is not breathing, the American Heart Association recommends you get on their chest and push on it, one human being pushing on another human being,” Sawaya said.
“Statistics show mechanical compression is more effective overall at circulating blood throughout the whole body,” he said. “We’re kind of at the cutting edge in using this device.”
The department was able to replace its aging defibrillators together with new Autopulse units and the corresponding Zoll-X-Series monitors. The Autopulse performs and records compressions. The X-Series monitor records all the cardiac data, rate rhythm, blood pressure, breathing rate and carbon dioxide readings.
“The fully integrated system is designed to be a straightforward and streamlined experience,” said firefighter-EMT Evan Aas during a recent demonstration.
The Autopulse unit is equipped with a tarp that slides under the patient and aids in proper positioning onto a backboard. The EMT or paramedic then adjusts the straps of the compression band around the patient’s lower chest and activates the machine to begin delivering compressions.
“The battery-operated device continually gives compressions and automatically pauses briefly after each 30 compressions, allowing just enough time to press in some breaths using an airway mask,” Aas said.
“We warn family members that once turned on, the mechanical device can appear quite violent but it is safe and very effective,” said firefighter-paramedic Paul Pavolka.
“With this technology, we’re able to deliver continuous compressions even while moving a patient down a flight of stairs, around corners and into the aid unit,” said Pavolka. “That’s something we just couldn’t do before.”
Once inside the aid unit, treating a cardiac arrest is very intense. “We ventilate, do compressions, get someone intubated, get an IV going to administer drugs, get information, check blood sugars levels,” Pavolka said. “Trying to do all that while continuing to manually deliver compressions is less effective.”
“The first time we used this device on someone, the relative calm on the scene was incredible,” Aas said.
“We’ve used it three times so far and gotten very good feedback on it,” Sawaya said.
With these sweeping protocol changes in response to cardiac arrest cases and new equipment, all Key Peninsula firefighter-EMTs and firefighter-paramedics underwent extensive training on the system well before the department deployed it. “Most of KPFD’s volunteer firefighter battalion are also certified EMTs as well,” said Volunteer Battalion Chief Anne Nesbit.
There are two devices in service. The response-time goal for the department is eight to 12 minutes.
Pierce County Emergency Medical Service approved the use of Autopulse and the competing LUCAS system for use countywide in late March. Key Peninsula, Gig Harbor and city of Tacoma are currently the only jurisdictions in Pierce County utilizing this new technology, according to Sawaya.
“We’re excited to be leading the way for Pierce County,” he said.