New life-saving technology bridging links in Chain of Survival The Innovation Report showcases ground‑breaking prehospital care being delivered by the QAS. This report introduces the new state-of-the-art Corpuls Mechanical Chest Compression Device (MCCD) which can improve survivability for an important group of cardiac arrest patients. Statewide Reperfusion Coordinator Brett Rogers reports. Right
■ The mechanical chest compression device can improve survivability for an important group of cardiac arrest patients. Photos: Jo Hales and Matt Stirling
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Over the past 20 years, the valued efforts of QAS paramedics in treating patients for out of hospital cardiac arrest (OHCA) have been compiled to form a detailed and comprehensive collection. The gathered information provides important insights into patient outcomes and survival trends, showcasing the quality of prehospital care provided by QAS clinicians. OHCA survival rates reported by the QAS already compare very favourably with other national and international ambulance services.1,2 The management provided to cardiac arrest patients has evolved considerably over the past two decades, resulting in increased survival rates. However, there is still scope for improvement and we are committed to continuously evaluating the management provided to identify opportunities to further improve the care and outcomes for our patients. All links in the “Chain of Survival” – early access, early CPR, early defibrillation, early advanced life support, and early post resuscitation care – remain fundamental to survival. Central to our current practice is the delivery of high-performance CPR, early defibrillation, high quality compressions, minimisation of interruptions and the reduction of hands-off chest time. QAS paramedics have focussed on high performance CPR through “CPR Masterclass” workshops, and it is vital that these concepts remain a cornerstone of our care. However, there are circumstances that present significant challenges to the delivery of quality manual chest compressions. So, with
Winter 2020
increased availability of portable mechanical chest compression devices, the QAS has identified an opportunity to enhance the care we provide for a subset of potentially salvageable OHCA patients who present early with an identified reversible cause of cardiac arrest. MCCDs can provide uninterrupted high-quality chest compressions in situations where it is unlikely that chest compressions could otherwise be provided manually (e.g. during patient relocation or during transport to specialist definitive care). The use of MCCDs in combination with access to Percutaneous Coronary Intervention (PCI) and emergency Extracorporeal Membrane Oxygenation (ECMO) will, for certain patients, increase salvageability within an integrated, high performance health care system such as in Queensland. The QAS is preparing initial installation of 21 state-of-the-art Corpuls MCCDs, purpose built for the prehospital environment and selected following a rigorous evaluation process. The devices will firstly be rolled out in South East Queensland on selected Critical Care Paramedic (CCP) units that are in the catchment
