Cardiac arrest and cardiopulmonary resuscitation in “hostile” environments: Using automated compression devices to minimize the rescuers’ danger

Abstract

Mechanical automated compression devices are being used in cardiopulmonary resuscitation instead of manual, “hands-on”, rescuer-delivered chest compressions. The -theoretical- advantages include high-quality non-stop compressions, thus freeing the rescuer performing the compressions and additionally the ability of the rescuer to stand reasonably away from a potentially “hazardous” victim, or from hazardous and/or difficult resuscitation conditions. Such circumstances involve cardiopulmonary resuscitation (CPR) in the Cardiac Catheterization Laboratory, especially directly under the fluoroscopy panel, where radiation is well known to cause detrimental effects to the rescuer, and CPR during/after land or air transportation of cardiac arrest victims. Lastly, CPR in a coronavirus disease 2019 patient/ward, where the danger of contamination and further serious illness of the health provider is very existent. The scope of this review is to review and present literature and current guidelines regarding the use of mechanical compressions in these “hostile” and dangerous settings, while comparing them to manual compressions.

Keywords: Automated compression devices, Cardiopulmonary resuscitation, Cathlab, Computed tomography, Transfer, COVID-19

Core Tip: The use of automated compression devices in ‘hostile’ environments, both in in- and out-of- hospital cases of cardiac arrest, seems to be beneficial both regarding compressions’ quality but especially the rescuers’ safety. So far, while experimental data is extensive, real-life studies examining their use in non-friendly situations are still limited. Since high-quality cardiopulmonary resuscitation remains the key to a successful resuscitation, their use such difficult and “hostile” situations should be seriously taken into consideration. Noteworthy, such a use is indeed implied by guidelines.