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REFERENCES

2015 American Heart Association Guidelines for Cardiopulmonary Resuscitation and

Emergency Cardiovascular Care.

Circulation

2015; 132: S315-S573

European Resuscitation Council Guidelines for Resuscitation 2015,

Resuscitation.

2015;95:1-311.

Larsen A, Hjörnevik Å, Bonarjee V, et al. Coronary blood flow and perfusion pressure

during coronary angiography in patients with ongoing mechanical chest compression:

A report on 6 cases.

Resuscitation.

81.(2010)493–497.

Wagner H, Madsen Hardig B, Harnek J, et al. Aspects on resuscitation in the

coronary interventional catheter laboratory.

Circulation.

2010;122:A91 (Poster on file at

Physio-Control.)

Liao Q, Sjöberg T, Paskevicius A, et al. Manual versus mechanical cardiopulmonary

resuscitation. An experimental study in pigs.

BMC Cardiovascular Disorders.

2010;10:53 (open access; http://www.biomedcentral.com/1471-2261/10/53).

Wagner H, Madsen Hardig B, Steen S, et al. Evaluation of coronary blood flow

velocity during cardiac arrest with circulation maintained through mechanical chest

compressions in a porcine model.

BMC Cardiovascular Disorders

. 2011;11:73.

2005 International Consensus on Cardiopulmonary Resuscitation and

Emergency Cardiovascular Care Science with Treatment Recommendations.

Resuscitation.

2005;67:195.

Smekal D, Johansson J, Huzevka T, et al. No difference in autopsy detected injuries

in cardiac arrest patients treated with manual chest compressions compared with

mechanical compressions with the LUCAS device – a pilot study.

Resuscitation.

2009;80:1104-1107.

Oberladstaetter D, Braun P, Freund M, et al. Autopsy is more sensitive than

computed tomography in detection of LUCAS-CPR related non-dislocated chest

fractures.

Resuscitation.

2012;83(3):e89-90.

10 Mateos Rodríguez A, Navalpotro Pascual J, Peinado Vallejo F, et al. Lung injuries

secondary to mechanical chest compressions.

Resuscitation.

2012;83(10):e203.

11 Menzies D, Barton D, Nolan N. Does the LUCAS device increase injury during CPR?

Resuscitation.

2010;81S:S20. AS076.

12 Yost D, Gonzales L, Lick C, et al. Abstract 38: North American LUCAS Evaluation:

prehospital use of a mechanical chest compression system.

Circulation

. 2010;122.

A38. (Poster on file at Physio-Control.)

13 Rubertsson S, Lindgren E, Smekal D, et al. Mechanical chest compressions and

simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-

hospital cardiac arrest: The LINC Randomized Trial.

JAMA.

2014;311:53-6.

14 Vanden Hoek T, Morrison L, Shuster M, et al. Part 12: Cardiac Arrest in Special

Situations: 2010 American Heart Association Guidelines for Cardiopulmonary

Resuscitation and Emergency Cardiovascular Care.

Circulation.

2010;122(18

suppl 3). (S834).

15 2010 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation

and Emergency Cardiovascular Care.

Circulation.

2010; 122: S640-S946

Summary of Contents for LUCAS 3

Page 1: ...tructor Guidebook Classroom and Hands On Training PHYSIO CONTROL TRAINING This is not the complete instructions for use Refer to Operating Instructions for complete device information including directions for use intended use and warnings ...

Page 2: ...2 LUCAS 3 Chest Compression System Instructor Guidebook ...

Page 3: ...Physio Control Inc Redmond Washington U S LUCAS 3 Chest Compression System Instructor Guidebook Classroom and Hands On Training PHYSIO CONTROL TRAINING ...

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Page 5: ...ation 29 37 Chapter 3 Small Group Hands on Training and Application Practice Learning Objectives 39 Roles Responsibilities and Expectations 39 Detailed Step By Step Overview 40 Real time Application Demonstration 44 Student Device Application 45 Completing the User Performance Evaluation 45 49 Chapter 4 Training Evaluation 53 Appendix A Important Contacts 57 Appendix B Frequently Asked Questions 6...

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Page 7: ...lassroom and hands on training in a manner consistent with training provided by Physio Control Refer to the Instructions For Use IFU for complete directions for use indications contraindications warnings cautions and technical specifications The IFU is included with each device All operators must read the complete IFU before operating the LUCAS chest compression system ...

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Page 9: ...Chapter 1 Instructor Training Preparation ...

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Page 11: ...rangements for resources such as LUCAS devices manikins and training materials accordingly prior to the training session FACILITY PLANNING AND LOGISTICS Each training session will require a classroom setting for the Introduction and Device Overview large enough to accommodate the audience attending In addition there needs to be ample space for multiple small groups with an instructor to student ra...

Page 12: ... of 40 will require seven devices manikins Each LUCAS device in Carrying Case should have the following present Suction Cup mounted to the Piston Patient Straps wrist straps attached to Support Legs Stabilization Strap present in Carrying Case with two Support Leg straps that buckle to Support Legs Two charged batteries one installed in device with spare in Carrying Case compartment External Power...

Page 13: ...hows the battery charge status 5 Push and hold the ON OFF button to turn on the device so the LUCAS device does a self test Make sure the ADJUST LED illuminates with no alarm or warning LED 6 Push and hold the ON OFF button for one second to power down the LUCAS device again 7 Charge LUCAS batteries as needed Installed in LUCAS device power supply cord less than two hours Put battery in the slot i...

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Page 15: ...Chapter 2 Classroom Training Introduction and Overview ...

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Page 17: ...on training and application practice Training evaluations Q A VIDEOS There are three videos that can be played at the beginning of each training session Have the videos prepared prior to starting the class All videos available for streaming and downloading at www physio control com LUCAS LUCAS 3 Chest Compression System First Use Preparation This video provides an overview of the LUCAS device firs...

Page 18: ...d loss of consciousness The LUCAS device must only be used in cases where chest compressions are likely to help the patient Contraindications Do NOT use the LUCAS Chest Compression System in these cases If it is not possible to position the LUCAS device safely or correctly on the patient s chest Too small patient if the LUCAS device alerts with 3 fast signals when lowering the Suction Cup and you ...

Page 19: ...m Clinical as well as autopsy studies have shown that LUCAS compressions are safe for the patient8 11 13 with the same type of side effects as for manual CPR Main Components The main parts of the LUCAS Chest Compression System include A Back Plate which is positioned underneath the patient as a support for the external chest compressions An Upper Part which contains the proprietary and rechargeabl...

Page 20: ...ent The case and power on procedure will be reviewed in more detail later during the Application Demonstration Instructor Notes Begin with a complete LUCAS chest compression system packed in the Carrying Case on a table at the front of the room and visible to the attendees As you review each component and aspect of operation physically remove the component from the case and demonstrate to the audi...

Page 21: ...he rods on each end of the Back Plate are where the Claw Locks on the Support Legs attach the Upper Part to the Back Plate The LUCAS device is specifically designed to be used with the LUCAS Back Plate It cannot be applied directly to any other backboard or transportation device Carrying Case Contents In addition to the Back Plate and the Upper Part including battery the LUCAS device is delivered ...

Page 22: ...e to become too hot The LUCAS device has an IP43 rating which is the level of ingress protection against particulate matter first number and liquid second number A rating of 3 for liquid indicates protection against spraying water such that water falling as a spray at any angle up to 60 degrees from the vertical will not have a harmful effect This is consistent with what you would expect from rain...

Page 23: ... tip of the sternum xiphoid process but over the lower edge of the main body of the sternum If the Pressure Pad is not in the correct position there is an increased risk of damage to the rib cage and the internal organs Also the patient s blood circulation is compromised The Suction Cup is disposable and should be replaced after each use To replace the Suction Cup pull it off the black mounting tu...

Page 24: ...ation of the Stabilization Strap if it prevents or delays any medical treatment of the patient Once the device is active Remove the Stabilization Strap from the Carrying Case and extend the strap fully at the buckles Carefully position the cushion of the Stabilization Strap behind the patient s neck as close to the patient s shoulders as possible Connect the Buckles on the Support Leg straps to th...

Page 25: ...ve the Suction Cup up or down To adjust the start position of the Suction Cup manually push down the Suction Cup extending the Piston with two fingers onto the chest of the patient ensuring the pressure pad touches the patient s chest Press the PAUSE button labeled with a 2 to lock the Piston in the Start Position Also use this when you want to stop the device and temporarily pause compressions bu...

Page 26: ...re information about data will be covered in the LUCAS Report Generator Quick User Guide flyer Caution Radio frequency communications can affect other medical electrical equipment Battery The Battery is in the Hood opposite the Control Panel The Lithium Polymer battery has a runtime of 45 minutes when fully charged If the battery is fully depleted it takes less than two hours to charge when the po...

Page 27: ...ice can run for as long as needed on a nominal patient chest when connected to the Power Supply It is recommended to replace the battery every three to four years or after 200 uses of more than 10 minutes each time Patient Size Remember do not use the LUCAS device if the patient is too small the LUCAS device alarms with three fast signals and you can t enter the PAUSE or ACTIVE modes or if the pat...

Page 28: ... acid solutions Follow the handling instructions from the manufacturer of the disinfectant When putting the device back in the Carrying Case ensure the DC input is placed downward Putting the LUCAS device in this position makes it possible to charge the device through the Carrying Case charger access port and to check Battery charge status through the Carrying Case top window Loosen the Stabilizat...

Page 29: ...quick and easy to deploy Using the large zipper handles unzip the case While the device is still in the bag push the ON OFF button for one second to power on the device You will hear a few tones while the device does its self test to make sure it s ready to operate before applying to the patient Instructor Notes Put a half manikin Brad CPR Manikin or comparable on the floor or table and ask for a ...

Page 30: ...while placing the Back Plate under the patient immediately below the armpits You can use several procedures to do this either lift the patient s torso and slide the Back Plate under from the head or log roll the patient and slide the Back Plate in from the side 3 Start manual CPR again 4 Hold the handles on the Support Legs to remove the LUCAS Upper Part from the case Pull the Release Rings once t...

Page 31: ...for a click 7 Pull up once to make sure the parts are correctly attached Adjustment and Operation Remember the compression point should be at the same spot for manual CPR according to the Guidelines When the Pressure Pad in the Suction Cup is in the correct position the lower edge of the Suction Cup is immediately above the end of the sternum but not over the xiphoid process 1 Use your finger to m...

Page 32: ...ressure Pad is pushed down too hard or not touching the chest fully the device will adjust the Pressure Pad by up to 30 mm 1 2 inches in either direction to the correct start position Some users will use a marker to draw a line on the chest around the top and or bottom of the Suction Cup to help monitor placement during operation The LUCAS Stabilization Strap helps secure the correct position duri...

Page 33: ...the patient are safely positioned on the transportation device and the device stays in the correct position and angle on the patient s chest Always monitor the position of the Suction Cup If the position changes during movement immediately push ADJUST to adjust the position Always use the Stabilization Strap to help secure the correct position Defibrillation Defibrillation can be performed while t...

Page 34: ...naging the airway during cardiac arrest will vary depending on the provider experience EMS or healthcare system protocols and the patient s condition With a non secured airway e g bag valve mask use the ACTIVE 30 2 mode so the LUCAS device performs 30 compressions then pauses for three seconds to allow for two ventilations With a secured airway e g endotracheal tube ventilation and chest compressi...

Page 35: ...on the number of students divide the room into groups of no more than six students for every instructor by counting off around the room sequentially up to the number of groups e g if there are 36 people in the class there will be six groups of six so have each person count sequentially up to six then start over The numbers correspond to the group they will be in after the break ...

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Page 37: ...Chapter 3 Small Group Hands on Training and Application Practice ...

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Page 39: ...se data transmission including what tool is used and what data is captured State the considerations for defibrillation when using the LUCAS device Understand the importance of resuming manual CPR if the device alarms or does not operate properly Successfully complete the LUCAS 3 User Performance Evaluation Reproduce the hands on training for their own staff ROLES RESPONSIBILITIES AND EXPECTATIONS ...

Page 40: ...iew Operation Case placement powering ON the device and applying the Back Plate Removing Upper Part from case and attaching to Back Plate Adjusting Readjusting the Suction Cup and positioning on chest Active modes and associated prompts Stabilization Strap Defibrillation Patient transportation Changing Battery during the LUCAS device operation Data transmission and review Instructor Notes Each ins...

Page 41: ...Back Plate under patient immediately below patient s armpits Key points Reiterate the Back Plate can be oriented in either direction and the graphic is only intended to provide a reminder of where to orient the Back Plate in relation to the patient and where to position the Piston and Suction Cup To place the Back Plate you can either lift the patient s torso and slide the Back Plate under from th...

Page 42: ...ort Leg through the other rescuer s arms If necessary the other rescuer when they are stopping manual CPR can grab the Support Leg and help guide it into position 8 Pulls up once to ensure attachment 9 Positions the Suction Cup immediately above the end of the sternum in the center of the chest and adjusts if necessary Key points Demonstrate physically feeling for the end of the sternum and guidin...

Page 43: ...vice can operate for prolonged periods while on external power but emphasise that a Battery always needs to be installed in the device for it to operate Explain you must detach the power supply cord by pulling back on the plastic connector Do not pull the cable directly as this can damage the charging port With LUCAS device paused emphasise the following 1 Make sure no pads or wires are under the ...

Page 44: ...t s fully seated and safely attached by spinning the Suction Cup and giving it a gentle tug 3 To transmit post event data from the LUCAS device ensure it is turned off then press the TRANSMIT button Further instructions about data transmission can be found in the LUCAS Report Generator Quick User Guide insert 4 Remember to place the LUCAS device with the charge port facing down into the case This ...

Page 45: ...inuous and start LUCAS compressions The goal is to complete steps 7 through 12 in less than 20 seconds to minimize interruptions to chest compressions at device application Note this time on the form If the time is 20 seconds repeat the evaluation of the student After each application review the steps the student did well then provide positive constructive feedback on any steps they did not comple...

Page 46: ...of the hands on training and application practice Each student will take turns acting as the instructor while the instructor takes the role of the student Instructor Notes As each student teaches LUCAS device application ask questions as needed to ensure the student covers each step appropriately At the conclusion of the hands on training and application practice return to the classroom for traini...

Page 47: ...3 SMALL GROUP HANDS ON TRAINING AND APPLICATION PRACTICE 47 ...

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Page 49: ...Chapter 4 Training Evaluation ...

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Page 51: ...training quiz that includes the correct answers highlighted in yellow Under each question there is an explanation of the answer from the IFU including the page numbers where the answers can be found LUCAS Device Training Evaluation and Feedback Form Students are strongly encouraged to complete this form and leave it with the instructor or other person designated on the day of the training prior to...

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Page 53: ...Appendix A Important Contacts ...

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Page 55: ...5 Physio Control Customer Service http www physio control com Select your country at the top of the page and select Contact Us General LUCAS 3 Device Inquiries Product Manager LUCAS Chest Compression System LUCAS3 physio control com ...

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Page 57: ...Appendix B Frequently Asked Questions ...

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Page 59: ...elines AHA or ERC The 201015 20151 AHA Guidelines state Priorities for the pregnant woman in cardiac arrest are a provision of high quality CPR and relief of aortocaval compression 2010 If left lateral tilt is used to improve maternal hemodynamics during cardiac arrest the degree of tilt should be maximised However at a tilt greater than or equal to 30 the patient may slide or roll off the incline...

Page 60: ...emergency resternotomy is not immediately available Class IIa LOE C 15 Taking this information and the LUCAS Instructions for Use into consideration the physician or medical director can best determine whether it is appropriate to use the LUCAS device for patients with cardiac arrest after cardiac surgery Q Q I ve heard the LUCAS device provides such good circulation to the brain that patients can...

Page 61: ...zepines and or opiate or no specific management The incidence implications and prognostic value of CPR induced consciousness remains unknown Increased awareness by rescuers of the presence of CPR induced consciousness and development of consensus based guidelines to treat this condition are required 18 Always follow your local protocols Q Q Can the LUCAS device be used at an angle such as when goi...

Page 62: ...first number and liquid second number As defined in international standard IEC 60529 Ed 2 1 clause 4 1 a rating of 3 for liquid indicates protection against spraying water such that water falling as a spray at any angle up to 60 from the vertical shall have no harmful effect This is consistent with what you would expect from rainfall Do not immerse LUCAS device in liquid The device can be damaged ...

Page 63: ...y requirements of updates and changes on a case by case basis Q Q How much force does the LUCAS device apply to the patient s chest A A Individual chests require different forces to be compressed 53 mm 2 1 inches LUCAS monitors each compression senses and automatically adapts the force required to reach the correct compression depth on each patient Q Q How quickly do the LUCAS Batteries deplete du...

Page 64: ...ce weekly or after each use to ensure the device is ready for the next use Q Q Can I deploy and turn on the LUCAS device in a grain silo A A No Do not use the LUCAS device in conjunction with flammable agents Q Q How do I keep the Black Plate from sliding on hard surfaces A A Optional Back Plate grip tape is available from your sales representative Q Q Our system often operates in very cold enviro...

Page 65: ... not installed in the device is 0 C to 40 C 32 F to 104 F For complete Battery environmental specifications see Section 9 6 of the IFU Q Q Does the LUCAS device perform two inch compressions on every patient that fits in the device A A LUCAS device will perform compressions at a depth of 53 2 mm 2 1 0 1 on patients with a sternum height greater than 185 mm 7 3 The smallest patients patients with a...

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Page 67: ...Appendix C The LUCAS Device in the Cath Lab ...

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Page 69: ...ercutaneous coronary intervention PCI there is risk of cardiac arrest Although high quality chest compressions improve the chance of successful resuscitation and survival it is difficult to perform effective high quality chest compressions during PCI AHA Guidelines 2010 part 12 Special Circumstances p S84915 The AHA has given the use of mechanical CPR during PCI a class IIb recommendation based on...

Page 70: ...ior design of the LUCAS Piston means that cranial and caudal angulation views are necessary when performing angiography during the time the LUCAS device is in place Because of its radiotranslucency except for the Hood and the Piston the LUCAS device allows for all oblique projections except the straight anterior posterior This means the following projections can be obtained in monoplane LAO Crania...

Page 71: ...on time There was a case out of Minneapolis MN in which the LUCAS device provided compressions on a patient for two hours and 45 minutes The patient survived with no neurological deficits 19 Common Angiographic Views with the LUCAS Device The following images are from a test performed at Liverpool Hospital Cardiac Catheterization Lab in New South Wales Australia 20 The most common angiographic vie...

Page 72: ... arteries in cranial views The shadow of the Lucas Suction Cup may be partially visible RAO 3 CRA 32 Caudal view LUCAS 2 chest compression system allows for visualization of the coronary arteries caudal views LAO 39 CAU 31 Lateral view LUCAS 2 chest compression system Support Leg with screws causes minor artifact in lateral view LAO 51 CRA 25 ...

Page 73: ...nterior view The straight posterior anterior view cannot be used when the LUCAS device Upper Part is attached RAO 1 CAU 25 LAO 2 CRA 4 LUCAS PCI Back Plate without Upper Part attached in precautionary placement allows for full visualization of arterial tree ...

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Page 75: ...References ...

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Page 77: ...a T et al No difference in autopsy detected injuries in cardiac arrest patients treated with manual chest compressions compared with mechanical compressions with the LUCAS device a pilot study Resuscitation 2009 80 1104 1107 9 Oberladstaetter D Braun P Freund M et al Autopsy is more sensitive than computed tomography in detection of LUCAS CPR related non dislocated chest fractures Resuscitation 20...

Page 78: ...nary resuscitation A systematic review Resuscitation 2015 85 44 48 19 Case Study Nearly 3 hours of chest compressions by LUCAS buys time to save patient 2014 Physio Control GDR 3318844_A 20 Images courtesy of Dr Sydney Lo Director Liverpool Hospital Cardiac Catheterization Lab Sydney Australia 21 Rice DT Nudell NG Habrat DA et al CPR induced consciousness It s time for sedation protocols for this ...

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Page 80: ...dquarters 11811 Willows Road NE Redmond WA 98052 USA Tel 425 867 4000 www physio control com Physio Control Operations Netherlands B V Galjoenweg 68 6222 NV Maastricht The Netherlands Tel 31 0 43 3620008 Fax 31 0 43 3632001 Physio Control UK Sales Ltd 35 Great St Helen s London EC3A 6AP United Kingdom Physio Control Australia Pty Ltd Suite 4 01 15 Orion Rd Lane Cove NSW 2066 Australia Toll Free Te...

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