As the COVID-19 pandemic continues to affect daily life, Deer Grove Emergency Medical Services (DGEMS) made equipment investments to improve outcomes of patient experiencing cardiac arrest and provide a higher level of safety to the emergency responders. Early in June, DGEMS deployed Lucas mechanical compression devices made by Stryker EMS, and then in mid-July, DGEMS deployed Bullard EVA power air purifying respirators (PAPR).
In March, when more information circulated about the effects and possible potency of COVID-19 became available, all angles to add safety to medical emergencies were explored. It was learned the coronavirus is spread to EMS personnel through the administration of aerosolized procedures, which include high-flow oxygen, hand-held nebulizer treatments, metered-dose inhaler treatments, continuous positive airway pressure (CPAP) and cardio pulmonary resuscitation (CPR), to patients. Simple safety measures like applying face masks to patients and filters to nebulizers were instituted, but this still left a rather large possibility of exposure while caring for patients who are suffering from a cardiac arrest, said Eric Lang, DGEMS chief.
DGEMS purchased two automated, mechanical CPR devices, the Lucas CPR chest compression system, for each primary ambulance located in Cottage Grove and Deerfield.
The device performs hands-free, continuous chest compressions, increasing the probability of a good outcome for the patient and reducing the workload and health risk for first responders. With the device in action, EMS, fire and law enforcement personnel can concentrate on patient care and life-saving intervention for those in cardiac arrest.
According to the American Heart Association, sudden cardiac arrest affects nearly 500,000 people each year, but only a fraction of those patients leaves a hospital alive. Despite other advances in emergency medicine, early access to high-quality CPR and defibrillation is what most enhances cardiac arrest survival rates.
In addition to the introduction of the Lucas CPR device, Deer Grove EMS has implemented a high-performance cardiopulmonary resuscitation (HPCPR) model. Along with implementation of the Lucas CPR device, HPCPR will be used to bridge the gap between the patient going pulseless and the application of Lucas mechanical CPR. The key concept of HPCR is limiting each pause in chest compression to fewer than three seconds and eliminating any unnecessary pauses in compressions. HPCPR keeps blood flowing to the brain and heart, which in turn leads to better patient outcomes.
In recent years, survival numbers have increased as more bystanders are trained in CPR, as well as the prevalence of public automated external defibrillators (AEDs).
Because manual CPR is physically demanding, making it difficult to provide the consistent, precise compressions, the chances of survival are often diminished. Additionally, manual CPR creates inherent risks for paramedics when transporting patients in the ambulance, as they are unable to effectively perform CPR while remaining safely secured in a seat.
The predicted exhaustion of the personal protective equipment supplies was the trigger for DGEMS to seek a more permanent solution to respiratory protection. This solution was found in a power air purifying respirator (PAPR) system, where the protective hood, blower and filter can be used more than once. In fact, the whole PAPR system can be reused by more than one provider, whereas the N95 respirator masks were discarded after a single use. As an additional benefit, the staff would not need to be fit tested to use the PAPR systems.
Through research and consultation with multiple vendors, it was found the Bullard EVA PAPR would be the best fit for the department and was also the most reasonably priced, Lang said.
The Bullard EVA (evolutionary air) represents the latest in cutting-edge Powered Air-Purifying Respirator (PAPR) technology designed to provide constant air flow in a compact, streamlined form for added customer comfort. EVA’s ergonomic, lightweight design makes this PAPR evenly balanced to provide maximum comfort to the wearer. This system is continuously working to maintain constant air flow, regardless of filter type, hood type, filter loading or battery capacity. In addition, EVA is equipped with an easy-to-read fuel gauge that lets the user quickly check the unit’s battery status.
When the EVA PAPR was placed into service, each member was given their own hood to use. DGEMS will not require members to share the protective hood, but they will share the blower and filter portion of the system.
The Deer Grove EMS Association, through donations collected from community members, provided financial assistance making both purchases possible.