Thursday, October 9, 2014

Helicopter-based in-water resuscitation with chest compressions: a pilot study

Article: Helicopter-based in-water resuscitation with chest compressions: a pilot study
Authors: Winkler, BL, et al.
Journal: Emergency Medicine Journal

I have covered some of Dr Winkler's articles in the past, primarily concerning mannequin-based in-water resuscitation studies.  This article reviews a recent pilot study he performed to evaluate a possible helicopter-based protocol for performing in-water resuscitation.  The protocol involves the following:

  • Dispatching rescue divers from a helicopter on scene
  • Deploying inflatable platform
  • Placing LMA airway and ventilating with Oxylator
  • Applying Lucas chest compression device
  • Inserting intraosseous needle
This rescue protocol was carried out in a wave pool from a simulated helicopter platform in calm and choppy water.  The idea of the study was to "investigate the feasibility and time requirement of the in-water resuscitation measures..."

I have always enjoyed reading the innovative study designs Dr Winkler comes up with, but what concerns me is that these studies may be missing the point and complicating things.  Many folks get caught up in fancy devices and techniques without focusing on basic airway techniques.  I understand where Dr Winkler is coming from and applaud his efforts to improve in-water resuscitation, but these articles need to be read with the understanding that any time used to insert devices and carried out complex protocols may be taking away from much needed ventilations and transport to advanced care.  In the case of helicopter rescue, it would be more beneficial, in my mind, to perfect protocols for getting a victim in to the helicopter and on the way to advanced care as fast as possible.  There is no reason to bring the resuscitation bay to the patient when you have a perfectly good one hovering right above you.  

Overall I am impressed that they were able to deploy and use all of this equipment in to the aquatic environment.  Definitely too many moving parts and too much room for error for my taste, but I enjoy the innovative science.