philips in cpr. 2 philips resuscitation technology solutions our goal is to relate philips in cpr...
TRANSCRIPT
Philips in CPR
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Philips Resuscitation Technology Solutions• Our goal is to relate Philips in CPR
directly to the 2005 AHA guidelines
– Quick Shock– SMART CPR– Q-CPRTM
Quick ShockOnly from Philips
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AHA Guidelines 2005
• Effective chest compressions are essential for providing blood flow during CPR
• Blood flow delivers small but critical amount of oxygen to brain and myocardium
• CPR increases the likelihood that a shock will be successful (i.e. will terminate VF and the heart will resume an effective rhythm and perfusion)
• When shock is indicated, it is critical it be delivered as soon as possible after chest compressions are stopped
• Reduction in interval between compressions and shock delivery by as little as 15 seconds can increase predicted shock success
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What is Quick Shock?
• Ability to deliver a shock in less than 10 seconds after CPR pause
• Unique feature offered only on Philips AEDs
• Available on all HeartStart OnSite, FRx and FR2+ AEDs
• Competitive devices take between 13 and 27 seconds to deliver a shock
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HeartStart FR2+ 9.98s
100%
80%
60%
20%
5 10 15 20 2500%
Survival
Time to shockin seconds afterCPR is stopped
40%
30
Survival data: Swine; 7 minutes of VF
Yu T, et al. Circulation. 2002; 106:368-372
Survival Linked to Speed of Shock Delivery After CPR
Times measured from end of Stop-CPR prompt, with AEDs at maximum energy
HeartStart HS1 & FRx8.1s & 8.4s
7Cardiac Science G3 & Zoll AED+
MedtronicLP500
HeartStart FR2+ 9.98s
100%
80%
60%
20%
5 10 15 20 2500%
Survival
Time to shockin seconds afterCPR is stopped
40%
30
DefibtechLifeline
Medtronic CR+ & Welch AllynAED20
Medtronic CR+ Auto
Times measured from end of Stop-CPR prompt, with AEDs at maximum energy
Cardiac Science G3 Auto
Survival Linked to Speed of Shock Delivery After CPR
Survival data: Swine; 7 minutes of VF Yu T, et al. Circulation. 2002; 106:368-372
HeartStart HS1 & FRx8.1s & 8.4s
Welch AllynAED10
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Why is Quick Shock Important?
• Relates directly back to the guidelines; a reduction in interval between end of compressions and shock delivery can increase predicted shock success
• Using Philips AEDs with Quick Shock, the chance of survival is 80% or higher
• In 8 out of 9 competitive AEDs, survival rate is 40% or lower
SMART CPROnly from Philips
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AHA Guidelines 2005
• Recommend EMS providers consider CPR before shock for un-witnessed events, particularly when arrival time is > 4-5 minutes
• When EMS call-to-arrival time > 4-5 minutes, victims who receive 1½ – 2 minutes CPR before defibrillation showed increased survival rates compared with those who received immediate defibrillation:– An increase in survival due to initial resuscitation– An increase in survival-to-hospital discharge– An increase in 1 year survival rate
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Defibrillating VF Doesn’t Always Restore Circulation• A patient with a coarse, spiky
rhythm typical of short-duration VF may still have an energetic heart & may benefit from an immediate shock
• A patient with a weaker, flatter rhythm typical of long-duration VF has a depleted heart and is unlikely to return to circulation with a shock
• Other contributors besides VF duration: Diseased heart, cause of arrest
– CPR first showed improved survival rates
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What is SMART CPR?
• Technology that analyzes the patient’s rhythm for you and determines whether to shock first or perform CPR first
• Reinforces Guidelines 2005 recommendation of CPR before shock for un-witnessed events, particularly when arrival time is > 4-5 minutes
• Takes the guesswork out of determining length of victim downtime especially for un-witnessed events
• Available only on the Philips HeartStart FR2+
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Why is SMART CPR Important?The Survival Curve
0 1 2 3 4 5 6 7 8 9 10
50
40
30
20
10
0
Ambulance Response Time (Minutes)
Probability Of Survival
(%) CPR first
Wik, et al. JAMA, 2003, 289;1389-1395
Shock first (traditional AED behavior)
At 4+ minutes of downtime, chance of survival decreases with traditional shock first therapy
Q-CPRTM
Only from Philips
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AHA Guidelines 2005
• Methods needed to improve quality of CPR• Increased emphasis on importance of chest
compressions - “push hard, push fast”• Components of quality CPR include ventilation
rate & duration, compression depth, compression rate & number, complete chest recoil, and hands-off time
• Hyperventilation, including too many breaths or too large a volume, diminishes cardiac output and survival
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What is Q-CPR?
• Q-CPR is the first and only CPR measurement and feedback tool integrated into an ALS monitor/defibrillator
• Q-CPR promotes high-quality CPR delivery
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Why is Q-CPR Important?
• Q-CPR measures the exact items specified by the AHA Guidelines
Compressions:• Compression depth• Compression rate• Leaning (incomplete release)• Duty cycle (duration )• No flow time (inactivity timer) Ventilations:• Volume low• Frequency high or low• Inflation time fast or slow
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Philips Resuscitation Technology Solutions… Leading the Way
• Quick Shock on all HeartStart AEDs• SMART CPR for trained first responders • Q-CPR; CPR Measurement and Feedback for
ALS professionals