Physio Control LUCAS 3, Инструкция для инструктора

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APPENDIX C / LUCAS IN THE CATH LAB
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The LUCAS Device in the Cath Lab
The LUCAS chest compression system facilitates the transportation of the patient to the
cath lab, and allows for catheterization and cath lab intervention during ongoing LUCAS
chest compressions. An emerging strategy for treating refractory VF cardiac arrest patients
where there is a suspicion of the underlying STEMI, is to transport the patient directly to the
cath lab for an emergency PCI. The LUCAS device is also used as a backup tool in the cath
lab in the event a PCI patient goes into a refractory, CPR-requiring cardiac arrest during a
coronary intervention.
THE 2010/2015 AHA/ERC GUIDELINES ON RESUSCITATION IN THE CATH LAB
Manual CPR during PCI is very difficult, involving compromises on circulation, intervention
and/or rescuer safety. The ERC and AHA guidelines outline the difficulty in performing
effective manual chest compressions on a patient in the cath lab while performing a
potentially lifesaving PCI.
“During both elective and emergent percutaneous 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 S849
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The AHA has given the use of mechanical CPR during PCI a class IIb recommendation
based on LUCAS publications alone, and the LUCAS device is designed for use in the
cath lab.
“It may be reasonable to use mechanical CPR devices to provide chest
compressions to patients in cardiac arrest during PCI” (Class IIb, LOE C-EO) )
- AHA Guidelines 2015, part 10 Special Circumstances, p S508
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Cardiac Arrest during Percutaneous coronary intervention
ERC writes in their latest guidelines:
“It is of extreme importance that chest compressions are not interrupted for
angiography. On an angiography table with the image intensifier above the patient,
delivering chest compressions with adequate depth and rate is almost impossible
and exposes the rescuers to dangerous radiation. Therefore, early transition to the
use of a mechanical chest compression device is strongly recommended.”
ERC Guidelines 2015, section 4 Special Circumstances, p 170
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