AutoPulse®

Load-Distributing Band CPR

AutoPulse®

What it is?

• Automated chest compression device

• “Load-distributing band” (LDB) technology

What does it do?

• Chest compressions that humans can’t possibly do

• Consistent, uninterrupted (never gets tired)

• Moves more blood, more effectively

Consistent Compressions

• Each one the same

Custom Compressions

• Tailored to deliver 20% displacement to each patient

Safer Compressions• Load distribution = distributed force

AutoPulse Delivers…

AutoPulse Benefits

Patients• Increases chances of survival

Caregiver• Allows them to deliver patient care

• Free to deliver other important therapies

Organization• Helps save more lives

• Promotes “leading-edge” view

AutoPulse – Not Intended For

Traumatic injury

• Sudden physical injury

• Violence

AutoPulse compressions may Increase

Hemorrhaging, Resulting in Hypovolemia

Perfusion is the single most

important factor for successful

resuscitation

FACT:

Circulation is Critical for Survival

Provides oxygen to

preserve vital organ

function

Converts non-shockable

rhythms (asystole, PEA) to

shockable ones (VF, VT)

Peberdy MA et al. Resuscitation. 2003;58:297-308.

VF Changes Over Time

-0.4

-0.2

0

0.2

0.4

0.6

-0.4

-0.2

0

0.2

0.4

0.6

Onset of VF

5 Minutes VF

CPR and VF

-0.4

-0.2

0

0.2

0.4

0.6

-0.4

-0.2

0

0.2

0.4

0.6

5 Minutes of VF

After 3 Minutes of Effective CPR

Eftestol et al Circulation 2004;110;10-15

Coronary Perfusion and ROSC

Victims with CPP <15

mmHg do not achieve

ROSC.

The mean CPP with

manual compressions is

12.5 mmHg.

Coronary Perfusion Pressure

Predicts ROSC

Paradis NA et al. JAMA. 1990;263:1106-1113.

Coronary Perfusion and ROSC

A well perfused myocardium is more likely to

experience return of spontaneous circulation (ROSC)

Quality of CPR

Evidence and Effects

Guidelines 2010: CPR

Adequate rate of “at least 100/minute”

Compression [sternal] depth of “at least 2 inches (5 cm)”

Allowing complete chest recoil after each compression

Ventilation: 8 -10 breaths per minute

Minimizing interruptions in compressions

Avoiding excessive ventilations (8-10 breaths/minute)

Challenges to Effective CPR

Limits of sternal compressions

Poor quality compressions

• Inconsistent rate

• Poor depth

• Improper duty cycle

Harmful interruptions due to

• Clinician fatigue

• Patient movement

Incomplete release“…chest compressions were not

delivered half the time, and most

compressions were too shallow…”Lars Wik, MD et al. JAMA. 2005;293(1):299-304.

Manual CPR and Blood Flow

30% - 40% of normal flow

Manual CPR provides less than optimal blood flow to

the heart and brain

10% - 20% of normal flow

Kern KB Bailliere’s Clinical Anaesthesiology. 2000;14(3):591-609.

20

94%

72%

60%

38%

0%

20%

40%

60%

80%

100%

<10.0 10.1-20.0 20.1 - 30.0 >30.0

Sh

oc

k S

uc

ce

ss

Pre-Shock Pause (sec)

p=0.002

Edelson et al, Resuscitation. 2006; 71:147-145

Pauses

How Much Does It Matter?

Sure, Smart, Safe

21

Positioning Strategy

Load Distributing Band Mechanism

Three Points of Focus

The only mechanical CPR system to

show significant clinical benefits in

comparative human trials.Sure

Intelligence that optimizes compressions

for each patient.Smart

Effective compressions without the risk

of higher injury rates.Safe

Improved Vital Signs

Human Studies Show

Systolic BPs > 100 mmHg

SpO2 Values Consistently > 90%

Increased CO2 levels

Timerman et al. Resuscitation 61 (2004) 273–280

Swanson et al. Circulation 2008:118:S-767

Duchateaux et al. Intensive Care Med 101007/s00134-010-1784 Gonin et al. Rev des Samu 2005;27:152-3. Liu et al. Chinese Critical Care Medicine 2010 Nov;22(11):660-2.

Multiple comparative studies

demonstrated vital signs improve in

humans because the AutoPulse

drives superior blood flow.

Timerman et al. Resuscitation 61 (2004) 273–280

Swanson et al. Circulation 2008:118:S-767

Duchateaux et al. Intensive Care Med 101007/s00134-010-1784 Gonin et al. Rev des Samu 2005;27:152-3. Liu et al. Chinese Critical Care Medicine 2010 Nov;22(11):660-2.

Timerman et al. Resuscitation 61 (2004) 273–280

Swanson et al. Circulation 2008:118:S-767

Duchateaux et al. Intensive Care Med 101007/s00134-010-1784 Gonin et al. Rev des Samu 2005;27:152-3. Liu et al. Chinese Critical Care Medicine 2010 Nov;22(11):660-2.

Timerman et al. Resuscitation 61 (2004) 273–280

Swanson et al. Circulation 2008:118:S-767

Duchateaux et al. Intensive Care Med 101007/s00134-010-1784 Gonin et al. Rev des Samu 2005;27:152-3. Liu et al. Chinese Critical Care Medicine 2010 Nov;22(11):660-2.

Timerman et al. Resuscitation 61 (2004) 273–280

Swanson et al. Circulation 2008:118:S-767

Duchateaux et al. Intensive Care Med 101007/s00134-010-1784 Gonin et al. Rev des Samu 2005;27:152-3. Liu et al. Chinese Critical Care Medicine 2010 Nov;22(11):660-2.

Sure

Improved Coronary Perfusion

Human Study

CPP produced by Load

Distributing Band was 33% higher

than with sternal compressions.

Timerman S et al. Resuscitation. 2004;61:273-280.

AutoPulse drives CPP to levels

sufficient to achieve ROSC.

Paradis NA et al. JAMA. 1990;263:1106-1113.

*p=0.015

Sure

CPP drops quickly

when AutoPulse

compressions stop

Manual CPR

CPP returns after

several AutoPulse

compressions

AutoPulseAutoPulse

Human Hemodynamics Study

Timmerman S et al. Resuscitation. 2004;61:273-280.

Improved ROSC

AutoPulse consistently shows improved ROSC

rates compared to sternal compressions.Sure

Improved Survival to Discharge

Ong et al. Circulation 2010;122:A100Ornato J et al. JAMA. 2006;295(22):2629-2637.

Controlled trials in humans demonstrate the

AutoPulse improves survival.

1,011 patients

OR, 2.27; 95% CI, 1.11-4.77

783 patients

OR: 3.99; 95% CI, 1.06-15.02

Sure

IMPROVEMENT IMPROVEMENT

Individualized Compressions

Smart

AutoPulse delivers a 20%

anterior-posterior

compression for each

patient.

Accounts for patient-to-

patient variability

2-inch compression has different effects

on varying chest sizes.

Human Anatomies Differ

Force Adjusted to Chest Stiffness

Smart

The AutoPulse Load Sensor

Control system adjusts force to

insure the difficult [larger, stiffer]

patients get the correct

compression.

Designed to deliver target

compression on patients through

the 95th percentile for size and

stiffness.

Tomlinson AE, et al., Compression force-depth relationship during out-of hospital cardiopulmonary

resuscitation, Resuscitation 2006.07.017

The force required to deliver an adequate chest

compression can differ by 400 percent.

Human Chest Stiffness

Automatically Sized to Patient

Every patient gets a safe and effective

compression.Smart

Eliminates operator error

• No under compression

• No over compression

Minimizes risk of

chest injury

Ensures complete chest

release to optimize

circulation

Review Resuscitation Events

Debriefing of actual resuscitation

events can be a useful strategy to

improve future performance, Class IIa

AutoPulse & RescueNet® Code Review

The most comprehensive out-of-hospital

review system

• Both manual CPR and AutoPulse

compressions

• Plus shock, monitor, intervention data

Smart

Force Distributed Safely

AutoPulse delivers twice the force of

manual compressions.

Force dispersed over large surface area

of the LifeBand.

More effective compressions

without risk of higher injury rates

Safe

Safe

Operates below Injury Threshold

If the amount of pressure applied to chest equals 6 pounds per

square inch, the risk of chest compression injuries climbs.1

1.Knoell CK. Thoracic response to blunt frontal loading SH. Published by

Society of Automotive Engineers, Inc. 1976.

The pressure applied to the chest with AutoPulse

is well below the injury threshold.

Safe

Detects and Alerts Un-Safe Situations

Automatic detection of

LifeBand out of starting

position

Unexpected patient

movement

Incorrect patient alignment

The AutoPulse minimizes patient injury by halting

compression should the patient or LifeBand move to

an unsafe position.

In Summary

The only mechanical CPR system to

show significant clinical benefits in

human comparative trialsSure

Smart

Effective compressions without the risk

of higher injury ratesSafe

Intelligence that optimizes compressions

for each patient.