CPR Compressions: The Manual Technique Versus the Automation of Medical Technology

Cardiopulmonary Resuscitation (CPR) compressions, in general, are manually performed by a rescuer in conjunction with rescue breathing (formerly known as mouth-to-mouth) to maintain the circulation of oxygenated blood in someone who is in cardiac and respiratory arrest. The goal is to prevent the permanent death of the individual and for him or her to regain a spontaneous pulse with adequate respirations. Two devices, the Thumper and the Auto-Pulse are used in some areas of the United states to provide automated CPR compressions to victims in cardiac arrest. The Auto-Pulse for example, requires the individual to be aligned on a platform. The chest band, known as LifeBand, is closed over the chest and a start button is pressed. Should this newer method replace the old one?

Evaluating The Provisions of Medical Technology

Mechanical CPR devices such as the Auto-Pulse are in use within some Emergency Medical Services (EMS) systems in the U.S. They certainly are not welcomed, however, by all systems because of the different experiences and opinions held by health care providers as well as the results of studies that compared the effectiveness of CPR compressions to those of automated ones delivered by the Auto-Pulse. According to the article, "Life or Death Question: Is Man or Machine Better at CPR?" by Rebecca Catalanello, the findings of two studies comparing manual CPR compressions with automated ones were published in 2006 in the Journal of the American Medical Association.

The first one carried out in Richmond, VA appears to support embracing the current Auto-Pulse that medical technology has to offer. Twenty-one percent of patients who received automated CPR compressions survived until admission into the hospital compared to eleven percent of the patients who were treated with manual CPR. This, however, is not the end of the story. The second trial took place in 5 sites within the U.S. and Canada which revealed that only 5.8% of the patients who received automated CPR survived to be discharged from the hospital compared to 9.9% of those who were treated with manual CPR.

Many health care providers believe that medical technology is certainly on the right road to the development of a life-saving device that delivers high quality, automated CPR compressions, but that such a technology has not yet arrived. Obviously, the skill to perform manual CPR will probably always be needed. First, the Auto-Pulse, even where it is employed, is not used when there's trauma (injury) to the chest. Also, the cost of these machines is enough to deter some EMS systems from purchasing them and the average layperson isn't able to afford one.

My Experience With CPR Compressions

The goal of medical technology and health care providers in emergency medical situations such as someone in cardiac arrest is for the patient to regain a spontaneous pulse, respirations, and survive to be discharged from the hospital. The best way of achieving that should be embraced whether that means accepting this medical technology of devices such as the Auto-Pulse or rejecting them for manual CPR compressions. The EMS system in my area does not embrace the automation of the Thumper or the Auto-Pulse.

I was trained to perform health care provider manual CPR and in the use of an Automated External Defibrillator (AED) for someone in cardiac arrest, and my real-world experience is with this method so I can't honestly argue for or against the automation of the Auto-Pulse. Few people who are not health care providers realize just how physically exhausting manual CPR is, especially on an adult. The idea of automation certainly sounds good when considering the fatigue aspect, nevertheless, the easier way of doing things is not always the best.