Washington University Emergency Medicine Journal Club – March 2025
Vignette
You’re working a TCC shift when you encounter a patient brought in by EMS in cardiac arrest. He is a 58-year-old male with a witnessed cardiac arrest with bystander CPR. On EMS arrival they switched the patient over to the LUCAS II chest compression system for transport. The patient was initially in ventricular fibrillation and received shocks X 3, Epi x3, and amidoamine x1. Total down time prior to arrival is only 20 mins. You move the patient over to the hospital stretcher and he is intubated while he is hooked up to our devices. During his first rhythm check he is found to be in PEA and compressions are continued with the LUCAS device. You notice that his ETC02 during compressions is 8. Given his short down time with bystander CPR, you expected him to have better ETCO2. You wonder if compression quality would be better with manual compressions instead of the LUCAS device…
PICO Question
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Search Strategy
Article 1: Hallstrom A, Rea TD, Sayre MR, Christenson J, Anton AR, Mosesso VN Jr, Van Ottingham L, Olsufka M, Pennington S, White LJ, Yahn S, Husar J, Morris MF, Cobb LA. Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial. JAMA. 2006 Jun 14;295(22):2620-8. doi: 10.1001/jama.295.22.2620. PMID: 16772625. Answer Key(Pending)
Article 2: Perkins GD, Lall R, Quinn T, Deakin CD, Cooke MW, Horton J, Lamb SE, Slowther AM, Woollard M, Carson A, Smyth M, Whitfield R, Williams A, Pocock H, Black JJ, Wright J, Han K, Gates S; PARAMEDIC trial collaborators. Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. Lancet. 2015 Mar 14;385(9972):947-55. doi: 10.1016/S0140-6736(14)61886-9. Epub 2014 Nov 16. PMID: 25467566. Answer Key(Pending)
Article 3: Rubertsson S, Lindgren E, Smekal D, Östlund O, Silfverstolpe J, Lichtveld RA, Boomars R, Ahlstedt B, Skoog G, Kastberg R, Halliwell D, Box M, Herlitz J, Karlsten R. Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial. JAMA. 2014 Jan 1;311(1):53-61. doi: 10.1001/jama.2013.282538. PMID: 24240611. Answer Key(Pending)
Article 4: Larik MO, Ahmed A, Shiraz MI, Shiraz SA, Anjum MU, Bhattarai P. Comparison of manual chest compression versus mechanical chest compression for out-of-hospital cardiac arrest: A systematic review and meta-analysis. Medicine (Baltimore). 2024 Feb 23;103(8):e37294. doi: 10.1097/MD.0000000000037294. PMID: 38394534; PMCID: PMC10883626. Answer Key(Pending)
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