Fla. fire rescue to use automatic CPR
By Rachael Joyner
BOCA RATON, Fla. — Paramedics at Fire Rescue Station 1 in Boca Raton strapped in a test dummy, pressed a green button and watched as their new lifesaving machine went to work.
The machine's chest band rhythmically tightened and released.
They were learning how to use Boca Raton Fire-Rescue's newest addition: AutoPulse, which performs CPR on cardiac arrest victims.
Although they haven't used it on a patient yet, they're excited about what it can do.
"It's a lot safer and more effective," EMS Capt. Frank Montilli said. "It takes the place of a paramedic. It frees us up to do other things."
Boca Raton has joined fire-rescue departments in Delray Beach, Lake Worth, Palm Beach and West Palm Beach that are using the device.
About 1,000 Americans die each day from cardiac arrest, according to the National Heart Association.
Even when paramedics perform cardiopulmonary resuscitation or CPR, compressing the chest to keep blood circulating to the heart and the brain, 95 percent of people die before reaching the hospital, according to the National Heart Association.
Some fire-rescue departments hope to improve the survival rate with the AutoPulse. Using a backboard that looks similar to a stretcher and a 5-inch-wide band, the device performs chest compressions at the push of a button. An internal computer calculates the patient's size and shape, so it can deliver chest compressions at the right frequency and pressure.
The device, created by ZOLL Medical Corp., a Massachusetts-based company that develops resuscitation equipment, has been on the market for four years.
But fire-rescue departments have been slow to buy it because of its high price. The device is $15,000, plus upkeep costs. It runs on $400 batteries — good for one to three years — and uses a $125 compression band, which can be used only once, according to Lt. Bob Nelligan of Boca Raton Fire-Rescue.
Boca Raton Fire-Rescue has outfitted three of its seven rescue trucks with the device. The department spent eight months researching the machines and bought them using grant money, spokesman Frank Correggio said.
"We're waiting for another grant to come through, so we can buy them for the rest of our trucks," he said.
Palm Beach County and Boynton Beach Fire-Rescue departments don't use the AutoPulse.
"We're aware of the product and are going to evaluate to see if it's cost-effective for our large department," Palm Beach County Fire-Rescue Capt. Don DeLucia said.
With 45 county rescue stations, it would cost nearly a half million dollars to outfit the department with enough machines, he said.
But Dr. Randall Wolff said the AutoPulse is worth the money.
"It's as good as if the heart were beating," said Wolff, EMS medical director for the Delray Beach, Lake Worth, Palm Beach and West Palm Beach fire-rescue departments. "They are costly, but if they save a life it's worth it."
Wolff was convinced of the device's merit after looking at scientific data that showed it improved blood flow better than manual CPR. He helped each of his fire-rescue departments find grants to get the machines. The goal is to eventually have them on every truck, he said.
Manual CPR, performed by a paramedic, restores about 40 percent of the blood flow to the brain and about 20 percent to the heart, according to the American Heart Association. Preliminary studies on patients who received compressions with the AutoPulse were 35 percent more likely to arrive at emergency rooms with a beating heart than those who had manual CPR. The AutoPulse increases the amount of blood circulation better, because it compresses the whole chest instead of manual compression in one spot, Wolff said.
"It's a lot better than we've had in the past. It's easy to use, and it's accurate," said Todd Soard, head of the National Association of Emergency Medical Technicians' Florida branch. "There is also no human ability factor. People get tired. You don't have to worry about this machine getting tired."
Although the Food and Drug Administration approved the device, some are wary of depending too heavily on a machine.
"If we rely too much on technology, people will think 'OK, I don't have to learn CPR,' " said Keith Carson, president of Alert Training Systems, a Lake Worth-based company that trains professionals and lay people in emergency response nationwide.
It has its pros and cons like any device, but it's a good investment for a rescue unit, he said.
Despite the hefty price tag, Boca Raton Fire-Rescue's Correggio thinks the AutoPulse will become the standard of care.
"They are expensive, but you can't put a price on a person's life," he said. "It's kind of a no-brainer."
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