Research Paper on "Resqpod in Cardiac Arrest"

Research Paper 10 pages (2845 words) Sources: 10

[EXCERPT] . . . .

ResQPOD in Cardiac Arrest

ResQPOD

The ResQPOD is an impedance threshold device which regulates thoracic pressure on demand during hypotension. This device effectively increases vital organ perfusion in the instance of a variety of arrhythmias even those associated with a very poor prognosis (Cooper & Cooper, 2008). The ResQPOD can effective, safely, and beneficially be incorporated into the training of emergency response personnel both in the field and in hospital settings to improve the survival rate of individuals experiencing Cardiac Arrest. Additionally, the value of the ResQPOD as both a research and retraining tool is great enough to offset the existing minimal expense of purchasing and training personnel in the successful implementation of the device in emergency situations (Rea et al., 2004).

Introduction:

A cardiac arrest is defined as the cessation of normal circulation resulting from irregularity of heart rhythm or the total cessation of the heart beating (Rea et al., 2004). This event may occur as the result of many internal and external physiological factors. Blood carries oxygen to the various organs and tissues of the body allowing for the carrying out of life sustaining functions driven by the rhythmic pumping of the heart. When normal rhythm is not restored to the heart promptly, loss of function of major organs as well as death may occur.

First responders both in and out of hospitals are trained in a variety of techniques used effectively to either restart the heart or to return it to normal rhythm (Thayne et al., 2005). The most popular of these techniques is manual Cardiopulmonary Resuscitation commonly abbreviated CPR. CPR utilizes manual chest depressions as well as oral ventilation to encourage blood profusion from vital organs as well as the circulation of newly oxygen rich blood (Wiggington, 2005). The rhythmic depression of the thoracic cavity is intended to encourage the heart either to begin beating again or to correct an arrhythmia.

Typically when emergency personnel are present in the instance of cardiac arrest they are equipped with a number of medical devices which facilitate more effective implementation of CPR methods (Wiggington, 2005). However, beginning in 1995 more extensive research began in terms of identifying the most effective methods of restoring regular rhythm (Wiggington, 2005). The face mask as well as endotracheal tube are common tools used to facilitate the most effective transfer of oxygen directly into the lungs of the incapacitated individual. However, it was observed that more than simple chest compression as well as the presence of oxygen were necessary to ensure a positive outcome for individuals in cardiac arrest. Hemodynamics, thoracic pressure, vital organ perfusion and oxygen saturation are all factors which contribute to a patient's ultimate outcome (Wiggington, 2005).

In an emergency situation, no matter the amount of training an individual has experienced, judgment is impaired as a result of the increased adrenaline and stress of the situation. The number of compressions administered as well as the amount of ventilation is subject to the specific training and experience of these first responders (Lurie et al., 2008). It has been shown conclusively that hyperventilation during CPR can have extremely negative consequences for the patient. Little research has evaluated the effects of hypoventilation on patients, however long-term oxygen deprivation of vital organs results in permanent tissue damage to those organs and disruption of their functioning (Lurie et al., 2008). It is important especially in the first minutes of CPR for emergency personnel to successfully impart the appropriate number of artificial breaths per minute as well as ensuring that the depressions are appropriately timed and spaced so that the muscles of the thoracic cavity can recoil completely (Lurie et al., 2008).

Impedance threshold devices are used in combination with either the face mask or the endotracheal tube. It is an electrical apparatus which prevents the influx of ventilation gases in between rescue breaths. This effectively forces an increase in circulation as a result of the vacuum created by the lack of gaseous influx following compression. The ResQPOD is a device which not only works with most standard CPR equipment but is also equipped with lights indicating the appropriate pace, duration, and time of administration of CPR ventilation. Further, ResQPOD is effective in the treatment of all types of cardiac arrest (Pirrallo et al., 2004).

Literature Review:

The ResQPOD is an electronic impedance threshold device. It works in conjunction with either the face mask or the endotracheal intubation which are used in CPR to facilitate the delivery of life saving oxygen to an individual experiencing cardiac arrest. The device itself is inexpensive and simple to use. The total training time required for an emergency medical technician to become fully proficient in the use of the device is one approximately two hour course (Lurie et al., 2003).

The ResQPOD specifically utilizes a system of flashing lights in order to indicate to the emergency personnel the appropriate number and duration of rescue breaths as well as the appropriate number of compressions. It effectively, when functioning properly, removes the aspect of human error in high tension emergency situations (Cooper & Cooper, 2008).

Function:

The ResQPOD does not in any way impede the ability of the patient to breathe. The impedance is overridden by the ventilation administered by the rescue personnel and is intended to be removed immediately upon return to normal sinus rhythm. Specifically the ResQPOD has been observed to increase blood flow to the brain and heart by as much as 50% (Pirrallo et al., 2004). The Pod's versatility is another positive in that it works effectively with all types of cardiac arrest.

This versatility is largely a result of its highly specific function. The Pod itself forms a vacuum in the thoracic cavity. When rescue breaths are administered, the impedance is over ridden and oxygen is allowed to enter the individual's lungs. However, when oxygen is not specifically being administered via emergency personnel, no gasses are allowed to enter the thoracic cavity. As the muscles of the cavity recoil from depression, blood is circulated nearly twice as effectively as when no impedance device is in place (Lurie et al., 2008).

Ventilation Rates:

The use of impedance devices allows for important research in ventilation rates. Currently there is no existing standard for the number of rescue breaths which should be administered between compressions (Rea et al., 2004). It has been shown though, that either too much oxygen or too little will ultimately result in a negative outcome for the individual. There are also a number of variables not formerly factored into research regarding the impact of ventilation rates on CPR outcomes.

There have been a number of studies both on field outcome as well as animal subjects in regard to the most effective number of rescue breaths. Previously it was believed that approximately 12 breaths per minute would be necessary to facilitate the most positive outcome for the individual (Wiggington, 2005). However, the greater the number of breaths, the lower the profusion rate of vital organs. When there are fewer breaths, oxygen is better able to permeate the system because of the more effective blood flow (Thayne et al., 2005). When there are too many breaths, blood is trapped ineffectively in the lungs. When there are not enough breaths administered, the pressure resulting from the impedance device builds dangerously not only in the thoracic cavity but the sharp increase in systolic blood pressure also negatively affects the brain and the heart (Lurie et al., 2003).

Though the ResQPOD significantly increases systolic blood pressure and profusion of major organs, a significant benefit beyond the immediate proven increase in positive medical outcomes, is the potential for the device's use in research (). Currently there is a great deal of research regarding not only ventilation but the relative significance of the first few minutes of CPR as well as the potential effects of patient "gasping" on the outcome and usefulness of CPR techniques ( ).

Implementation in the field:

A Staffordshire ambulance company was one particularly effective of field implementation of this device. Both levels of emergency response staff were trained in the use of the ResQPOD in the aforementioned two hour course. The relative success of the device was measured as the survival of the patient from the scene of the cardiac arrest to the treatment facility (). During the experimental period in the trial, there were no technical malfunctions and the results were significantly positive. This trial in particular highlighted the efficacy of the device in correcting cardiac arrest due to Asystoles which have a historically negative medical outcome.

Ultimately it was determined in this test as well as other similar that the cost of the devices and the cost in time and personnel the for use of this device is insignificant when taken in comparison to the multitude of benefits offered by IT'd devices and the ResQPOD in particular (Lurie et al., 2003). So effective both operationally and financially is the IT'd and again specifically the ResQPOD that the American Heart Association specifically recommends strongly the use of such… READ MORE

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