1. HeartSine samaritan PAD 500P...Saving lives in the Chain of Survival

2. When someone has a sudden cardiac arrest (SCA) what ultimately saves their life?

3. When someone has a sudden cardiac arrest (SCA) -Calling the ambulance or emergency assistance? -Using an AED? -CPR? -Paramedics or hospital care?

4. HeartSine is in the business of saving lives In the event of as SCA, what saves a life is ultimately a combination of steps that all must executed in order to maximise patient survival This is universally known as The Chain of Survival

5. Early recognition and activation of the emergency response system Early and effective CPR with a focus on chest compressions Early and rapid defibrillation Effective advanced post-cardiac arrest care

6. Chain of Survival Any one break in the chain drastically reduces the chance of survival and recovery from SCA… The HeartSine samaritan ® PAD 500P directly focuses on the first 3 links in the chain of survival

7. When a shock is not enough… What happens if you have an AED and the patient has a non-shockable rhythm ? Pulseless Electrical Activity (PEA) or asystole or a non-shockable rhythm? CPR is the most important treatment they can be given It is a key link in the Chain of Survival

8. DON’T NEED TREATMENT TREATABLE WITH AED (and CPR) TREATABLE WITH CPR 95%

9. The importance of CPR If a patient requires CPR the QUALITY of the CPR they receive is directly related to the patient outcome What does Effective CPR do? Prevents re-fibrillation (if a shock is successful) Maintains a shockable rhythm – increases the number of shocks Neurological outcome – helps prevent brain damage Limits cardiac and vital organ damage QUALITY CPR significantly increases the chance of survival when a shock alone is not enough

10. Effective CPR What are the components of good CPR? 1.Hand position 2.Compression rate 3.Compression depth 4.Minimising CPR “hand-off” (CPR fraction) 5.Ventilation's 6.Chest recoil Improvements in any one of these improves the effectiveness of CPR BUT…….. The more components you improve – the effect is multiplied

11. CPR Advisor – helps maximise CPR What are the components of good CPR? 1.Hand position 2.Compression rate 3.Compression depth 4.Minimising CPR “hand-off” (CPR fraction) 5.Ventilation's 6.Chest recoil SAM 500P CPR Advisor How does CPR Advisor do this for each?

12. CPR Advisor – improving CPR fraction - minimising hands off time No CPR being detected CPR detected after voice prompt Begin CPR! ICG waveform

13. CPR Advisor – improving Compression Depth Poor CPR force detected “Good CPR” after voice prompt Push Harder!

14. CPR Advisor – improving Compression Rate Poor CPR rate detected “Good CPR” after voice prompt Push Faster!

15. So why is CPR Advisor better than other CPR measurement systems? 1.No additional sensors required – detect all the CPR parameters through the attached electrodes 2.Accelerometers are uncomfortable for the user 3.Loss of tactile response – it feels un-natural 4.Gives feedback on both force and rate 5.Does not rely on a fixed depth like and accelerometer or force tranducer - does not take into account the size and shape of the patient 6.It requires a much greater physical effort for the rescuer to perform CPR with an accelerometer

16. Accelerometers have been shown to cause soft tissue damage! 1. Cho, Resuscitation; 80 (2009) Skin and soft tissue damage caused by use of feedback-sensor during chest compressions

17. SAM 500P with CPR Advisor vs Zoll AED Plus SAM 500PZoll AED Plus 1.1 Kg3.1 Kg No AccelerometerAccelerometer required “Push Harder” “Push Slower”No “Push Faster”No “Good Compressions” 8 seconds time to first shock 30 seconds time to first shock IP56IP55

18. SAM 500P with CPR Advisor vs Cardiac Sciences PowerHeart G5 SAM 500PCardiac Sciences G5 1.1 Kg2.6 Kg No AccelerometerAccelerometer required Not requiredAdditional voice prompts on where to place CPR sensor “Push Harder” “Push Slower”No – just says “Press, Press “Push Faster”No – just says “Press, Press “Good Compressions”No – just says “Press, Press 8 seconds time to first shock 15 seconds time to first shock IP56IP55

19. SAM 500P with CPR Advisor vs Philips FR3 SAM 500PPhilips FR3 1.1 Kg1.6 Kg (without accelerometer) No AccelerometerAccelerometer required “Push Harder”Extra device – no audio “Push Slower”Extra device – no audio “Push Faster”Extra device – no audio “Good Compressions”Extra device – no audio 8 seconds time to first shock IP56IP55

20. 1. All defibrillators are the same….they just give a shock and then tell the rescuer how to do CPR and have a metronome to guide you to the right pace -But metronome gives NO indication of depth – one of the most important components of CPR -Is it still easy to use once they get tired? -CPR Advisor will help ensure the quality of CPR does not deteriorate during the resuscitation period -CPR Advisor provides reassurance in an stressful situation that the rescuer is providing the best CPR possible Excuses not to use CPR Advisor

21. 2. The hospital/paramedics advised me to buy Zoll/Philips/Cardiac Sciences -Of course they did! They are all extensively trained on how to use these devices! -But if you have minimal training they are complicated to use -The minimally trained user may have never used this device before -Is the accelerometer in the right position? -It is un-natural to use an accelerometer -It can be painful to use an accelerometer Excuses not to use CPR Advisor

22. 3. But we get training on how to do CPR – we don’t need CPR feedback -Published studies have shown that CPR quality - among trained in-hospital professionals – can decrease in as little as 3 months -This is why hospitals, typically have CPR refresher courses every six months -Even trained professionals benefit from real-time CPR feedback

23. Key points to remember A shock on its own is not always enough – Chain of Survival The quality of CPR directly relates to survival outcomes Competitor CPR feedback technologies require additional sensors – confuse the user if NOT EXTENSIVELY TRAINED A shock AND high quality CPR can lead to survival rates of up to 75%

24. So if you want something more than just a shock box……. If you want a resuscitation defibrillator…….

25. HeartSine samaritan PAD 500P ……..not just a defibrillator