Feasibility and safety of automated chest compression during helicopter rescue with hoisting

TL;DR

A mechanical device for chest compressions is safer and more effective than manual compressions during helicopter rescues in mountainous areas.

Contribution

Demonstrates the feasibility and safety of mechanical chest compressions during helicopter hoisting in simulated mountain rescue scenarios.

Findings

Mechanical chest compressions achieved a significantly higher chest compression fraction than manual compressions.

The MCC device maintained guideline-recommended compression rates more consistently than manual methods.

No adverse safety events were observed during the use of the mechanical device.

Abstract

Out-of-hospital cardiac arrest (OHCA) in mountainous environments presents substantial logistical challenges, particularly in maintaining high-quality chest compressions during helicopter evacuations. Prolonged interruptions, especially during hoisting, may critically impact neurological outcomes. This study aimed to assess the feasibility and effectiveness of a mechanical chest compression (MCC) device compared to manual compressions during a simulated helicopter hoisting scenario.

This was a prospective, crossover simulation study involving complete mountain rescue teams. Each team completed two scenarios: one using an MCC device (LUCAS-3®) and one using manual chest compressions. Hoisting was performed at two heights (15 m and 30 m). The primary outcome was chest compression fraction (CCF). Secondary outcomes included, compression depth and rate, and overall safety of the procedure. Results are reported as mean ± standard deviation.

CCF was significantly higher in the MCC group compared to the manual group (96.6 % ± 0.3 vs. 73.9 % ± 6.6; p = 0.03). Compression rate was more consistently maintained within recommended ranges (103.0 ± 1.4 cpm vs 136.5 ± 8.7 cpm; p = 0.03 ). The guidelines-recommended range for chest compressions was significantly higher with the MCC device (89.5 % ± 9.6 vs 7.5 % ± 6.3; p = 0.03). No adverse safety events were observed.

In a simulated mountain rescue setting, the use of a mechanical chest compression device during helicopter hoisting appears feasible, safe and seems to improve chest compression fraction and the rate of guideline-compliant chest compressions.

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