Alachua County Fire Rescue is now the proud owner of three Lund University Cardiopulmonary Assist Systems (LUCAS), lifesaving devices that can apply nonstop mechanical chest compressions to cardiac arrest victims.
“Time is tissue,” said Rescue Lt. Sam Harper, a firefighter with 13 years of experience, “the more time we have good compression on a patient, the better the outcome for that patient.”
ACFR usually sees about 150 to 190 cardiac arrest cases each year, however in the past year the community has seen an increase in cases due to COVID-19 and limited hospital space, said Assistant Chief Michael Cowart.
For county residents suffering from cardiac arrest who live in rural areas miles away from the nearest hospital, treatment in an emergency vehicle can mean the difference between life and death.
When first responders are treating cardiac arrest victims in these conditions, manual compressions can be difficult to maintain.
The goal of chest compressions is to achieve return of spontaneous circulation (ROSC), which essentially means that the rescuers have gotten the heart to start beating again. One of the disadvantages of manual compressions is the number of times that rescuers have to stop their activity.
“It’s a lot of work,” Cowart said. “We typically have to swap out rescuers about every two minutes just so they don’t get fatigued.”
Without this equipment, there needs to be at minimum three people, and preferably four, in the back of an emergency vehicle to maintain it efficiently, Harper said. This machine not only frees up space and eliminates the need for at least two of those workers, but it also ensures that chest compressions will not cease.
“Every time you stop, you lose that blood pressure that you have been building up for the whole duration and then you have to get it back again,” Cowart said.
Treatment with the LUCAS device can even begin before the patient has been placed in the back of the emergency vehicle.
“One of the most difficult times to do CPR on patients is as we’re transferring from their house or from wherever the event occurred, to the stretcher,” said Harper.
With LUCAS, the device attaches to the patient and as a result can go wherever the patient goes.
“So, while we’re transporting them out of the house, carrying them down the stairs, wherever we’re moving this patient, CPR is continuously going,” said Harper.
Once the cardiac arrest patient finally arrives at the hospital, the LUCAS device can still help out with treatment. Just like in the back of an emergency vehicle, the new equipment can reduce the number of people that have to be treating a patient.
“Now you can move a lot of the people away and allow the doctors to do their thing and the nurses to do their thing,” said Shane Bateman, a rescuer with the ACFR.
In 2020, the LUCAS company gave the ACFR access to three of the devices for three months in order for AFCR to conduct a field study on how the equipment impacted the Alachua community. The results they saw were a huge success in the ACFR’s eyes.
During the trial period, the rates of ROSC in cardiac arrest patients went from 24% to 50%.
Harper, along with every other officer who used the equipment during the trial run had to undergo a three-day long training period.
“It’s repetitive,” Harper said. “You get that muscle memory built in if you do it the same way every time, it pretty much becomes second nature. Harper participated in three uses of the LUCAS equipment during the three-month trial run and said that he saw the device achieve ROSC in two of those cases.
ACFR was able to obtain this new equipment after receiving funding from the EMS Matching Grant through the Florida Department of Health. Cowart said that two years ago they applied for a grant to secure the equipment for all 20 stations, but the effort was denied. The ACFR then applied for just six devices this year, to have in their most rural stations, but only received funding for three.
Cowart said that after seeing the results of the LUCAS trial runs, they have the full support of the Commission and the Fire Chief.
“It’s just a matter of accessing funds,” Cowart said. With the warranty program, each LUCAS device is upwards of $20,000.
Cowart said they hope to be able to get a LUCAS device in each of the ACFR’s 20 stations.
Currently, the LUCAS devices reside in 20th, 81st and 41st fire stations and have been in circulation since Sep. 29, thought they have yet to be used in the field since then.
The ACFR is hopeful that this new equipment will have a strong impact on the Alachua community, especially as the COVID pandemic endures.
“I think it’s going to be a game changer when it comes to cardiac arrest management,” said Cowart.
