Use of ResQCPR
began in 2015
2014 2015 2016 2017
levels of consciousness, I added a new protocol
for sedating cardiac arrest patients to prevent
them from interfering with their treatment.
According to Pat McGrath, a paramedic
lieutenant for CFR, the numbers support what
the crews are seeing in the field. (See Figure 1.)
Prior to adopting the ResQCPR System,
just 7% of patients where ROSC was achieved
were discharged with normal neurological outcomes. After implementation, the number of
neurologically intact patients climbed to 47%.
McGrath comments on this amazing difference, saying, “We have had some patients
come by to see crews at the station. We know
we have had a significant increase in saves.”
In addition to improving outcomes, the
ResQCPR system improves safety for the
crews who, in the past, would perform CPR
during transport. As everyone knows, doing
CPR on the move is extremely difficult to do
without interruptions and changes in depth,
and can be unsafe for the rescuers, who traditionally had to perform CPR unbelted in the
The ResQCPR System allowed CFR to
change their approach toward cardiac arrest:
patients are no longer immediately put into
the ambulance and are instead kept on scene.
By working the cardiac arrest on scene,
crews have the best chance of getting the
patient’s heart going again. Transport is initiated once the patient is stable. While en
route to the hospital, the airway is managed,
medications are administered on board, and
crews know the patient has been given the
best possible opportunity to survive.
There are three primary takeaways that we
learned by implementing this technology:
1. ResQCPR is different than standard CPR.
Crews had to learn a new way of performing CPR and understand the three important differences.
First, the rate is slightly slower (80/min.)
than conventional CPR, allowing the heart
to refill longer.
Second, you’re actively lifting during
decompression rather than just allowing the
chest to relax on its own.
Third, you must use the ITD with ACD-CPR in order to optimize the intrathoracic
vacuum and perfusion. Commitment to the
training is critical to success. Crews may
assume that if they’re already good at CPR,
they don’t need to be trained on the system.
However, if they don’t learn how to use it correctly, they won’t be taking full advantage of
the improved perfusion the products provide.
2. You must first know how to do high-quality CPR before implementing these tools. If the
quality of your CPR is poor today, you won’t
be gaining much of anything by adding these
tools. But if your crews are already doing
high-quality CPR (rate of 100–110, depth
of 2 inches and compression fraction > 90%),
these devices will help make things even better. Systems that aren’t meeting those metrics
need to focus on the basics first.
3. It’s better to work the patient on-scene
instead of attempting CPR in the back of a moving vehicle. It’s virtually impossible to perform high-quality CPR safely in the back of
a moving vehicle. CFR crews only transport
after working the patient on scene using the
ResQCPR System and getting a pulse back. If
crews transport patients with ongoing cardiac
arrest, the use of ResQCPR is discontinued.
Ideally, patients transporting with ongoing cardiac arrest would be placed on an automated
CPR device, however, CFR’s current ambulance contractor doesn’t utilize this technology.
The ResQCPR System, which is made up of
two devices that enhance natural physiology,
provides for better cardiac output and bet-
ter cerebral blood flow during CPR, improv-
ing the patient’s likelihood of surviving an
out-of-hospital, non-traumatic cardiac arrest.
Implementing ResQCPR in a community
like Collierville, where high-quality CPR
was already the norm, has helped significantly
improve cardiac arrest survival rates. JEMS
Joe Holley, MD, FACEP, FAEMS, is medical director of Collierville (Tenn.) Fire and Rescue as well as the Memphis
( Tenn.) Fire Department and numerous other EMS agencies
in the region. He’s also EMS medical director for the state
of Tennessee and a member of the Metropolitan Medical
Directors (“Eagles”) Coalition. He can be contacted by email
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*Data from 2017 includes January through September only.
Figure 1: Annual ROSC rates (2014–2017*)