1. LUCAS 2 Compression Device
Medicare EMS Ltd

2. Objectives Explain in importance of Coronary Perfusion Pressure
Visit why quality CPR matters
Introduction of the LUCAS 2

3. Coronary Perfusion Pressure (CPP)
The coronary perfusion pressure is the difference between the aortic diastolic pressure and left ventricular end-diastolic pressure (LVEDP)
Normal values in normal coronary artery flow (TIMI III) is said to be between 15 – 70mmHg
CCP in cardiac arrest has been shown to need to be above 15mmHg for ROSC
Every interruption to compressions leads to a drastic fall in CCP that takes time to rebuild

4. Resus Council Guidance
30 compressions to 2 ventilations
Compression rate per minute
Depth of at least 2inces/5cm
Chest must be allowed to fully recoil
Minimise interruptions
Change every 2 minutes

5. Quality CPR Ultimately provides blood to the brain and heart
Generates Coronary Perfusion Pressure
Return of spontaneous circulation is thought to associated with a CPP of 15mmHg or above

6. Quality CPR
Large number of studies have shown that quality CPR is essential to achieve high CPP and successful defibrillation
As soon as CPR is stopped the CCP falls dramatically and takes up to 90 seconds to resume – rationale for changing from 15:2 to 30:2
Introduction of mechanical devices may solve this

7. Fatigue Ideally rotate every cycle/2 minutes
Fatigue will lead to poor quality compressions in rate and depth
Significant fatigue and shallow compressions have be shown after 1 minute

8. LUCAS 2
LUCAS2 is a mechanical compression device that has several benefits for the cardiac arrest patient;
Increased blood flow to the brain from 40% in normal CPR to 65%
Maintaining CCP of 15mmHg
Increase ETCO2
Reduction to compressions interruptions
Defibrillation during compressions

9. LUCAS 2 Uses: Contraindications: Adult patient in cardiac arrest
Must only be used for chest compressions ie not for external pacing
Contraindications:
Not possible to safely attach device
Patient too small/big

10. Control Panel
On/Off Adjust Pause Active – continuous Active – 30:2 Mute Battery life Alarm indicator

11. Activating the LUCAS 2
Push the On/Off button for 1 second to start self test
The LED (green) light will illuminate when the LUCAS is ready for use

12. Assembly Remove the back plate
Stop CPR and place back plat under patient below the arm pits
Start CPR

13. Assembly
Once LUCAS has been removed from its bag pull release rings to ensure claw locks are open
Straddle the patient
Attach one of the supporting legs to the back plate
Stop CPR
Attach the second supporting leg to the back plate

14. Adjustment Ensure the LUCAS in is adjust mode
Push the suction cup down with two fingers until the pressure pad is touching the patients chest – ensure no restriction the chest wall
Push the Pause button to lock the device in the start position (if the patient is too small for the device the warning alarm will sound resume CPR)
It should take no more than 20 second to attach the device to the back plate – get practicing!!!

15. Activation Check the suction cup is in the correct position. If not:
Push the Adjust button again and reposition
Push the Active button – either continuous or 30:2
Pressing Pause at any time will stop the device but it will still remember the start position
Apply the stabilisation straps – back of the neck the device and the wrists to the device

16. Defibrillation
Defibrillation can be performed whilst the device is active
The pads can be applied before or after the device – they should already be on the patient!
Ensure no wires or pads are trapped by the device
After defibrillation ensure the device is still in the correct position, adjust if necessary
The LUCAS need only be stopped for an ECG – the device should not be required if this is required!

17. Ventilation OP, NP, LMA or igel – operate the device in 30:2 mode
Deliver ventilations as per guidelines during the paused phase
ET – operate in continuous mode
The green LED light will illuminate 8 times per minute to indicate ventilation required

18. Transporting Remove the patient using available equipment as normal
Pause the device when rolling the patient
The device can be activated again when removing the patient
The device will stay in place even if the patient is tilted on a slight angle

19. Battery Remove the spare battery Push the Pause button
Pull the battery upwards to remove
Slot in the new battery
Wait until the pause LED light to illuminate
Push active to start the compressions again
The device will remember the start position for 60 seconds

20. Cleaning the Device Remove the contaminate suction cup
Do not immerse the device in water
Clean as per universal precautions
Ensure device is dry before repacking
Mount new suction cup by pulling over compressor