One issue which became apparent with this device in particular was the possibility for the lights which indicate the length and frequency of ventilation were prone to malfunctions. This issue has been addressed by the manufacturer and has been reasonably rectified to a standard of being able to be used confidently in emergency situations (Thayne et al., 2005). The potential danger of such a malfunction is apparent in a high risk situation. Though emergency personnel are trained in the correct technique of CPR method, in such high stress situations it is not uncommon for the adrenaline of the situation to result in over ventilation leading to a significant decrease not only in blood pressure but also in the efficacy of CPR itself.
The device since the manufacturing adjustment has been implemented in a number of real world emergency services. It has functioned since without fail and has been proven to increase the chances of recovery and survival by nearly half (Cooper & cooper, 2008). One additional benefit of the inclusion of the ResQPOD in the standard first response protocol is the necessary retraining of emergency personnel not only in the use of the device but also in updated CPR methods and theories (Wiggins, 2005). That is not to say that emergency medical personnel are untrained or somehow uneducated in the technique of CPR, however it is very likely that they have not acquainted themselves with all of the most recent research on a subject which is only one part of a larger and highly complex job. The wealth of research in subjects such as ventilation, the significance of the first few minutes of compression, even the benefit of beginning compressions even when specific ventilation is not yet in place are all crucial parts of the training that accompanies the addition of IT'd's to emergency protocol.
Human Trials v Animal Trials:
One of the most significant differences between the human and animal trials of this device is the ability to actually perform empirical clinical tests on the efficacy and versatility of the IT'd. This device is intended for use in the instance of cardiac arrest. To induce an arrhythmic state in a human participant would be unethical. As such, the only real world study of the efficacy of this device has come from its implementation in real emergency situations and the subsequent medical outcome of those new protocols. Because of the inability to actually test this device scientifically the only data available is that gathered in the field which is telling but incomplete.
The animal trials of this device though have proven to be extremely informative in the understanding of its implications as a research tool as well as providing useful data regarding the most effective CPR techniques and the relative effect of each technique on potential medical outcomes. One excellent example of such research is the studies done on pigs.
Pigs are physiologically very similar to human beings. In an effort to understand the most efficacious implementation of the device several pigs were sedated and put into arrhythmia before having CPR with the IT'd administered. During the experimental process their blood pressure, oxygenation level, and profusion rate were all closely monitored. One noticeable difference was the use of anesthetics which prohibited test subjects from gasping. In one study in which test subjects were deeply anesthetized, it was observed that it was impossible for subjects to gasp during the first few minutes of CPR (Lurie et al., 2003). It is possible for humans to gasp during CPR and it is a positive indicator for the medical outcome of the individual when they do gasp. However, when the sedated pigs did not gasp, it took longer for the arrhythmia to be corrected. This observation highlighted the relative significance of the autorespiration resulting from gasping in the ultimate outcome of CPR (Lurie e al., 2008).
Finally, in human trials it was observed that complications which arouse during the performance of CPR were unrelated to the use of the device. Rather existing medical conditions or human error were the sole cause of problems during the testing following the correction of the light problem which was solved completely and quickly by the manufacturer. Though used effectively to prevent the introduction of gases to the thoracic cavity between rescue breaths it was determined conclusively that the valve within the ResQPOD did not in any way impede the ability of the emergency personnel to administer ventilation or the ability of the patient to breathe successfully and without difficult even with the device attached (Cooper & Cooper, 2008).
With the implementation of any new procedure or material in an emergency protocol as vital as CPR it is important to test that procedure or material thoroughly. However, the nature of CPR and situations in which it is called for preclude the possibility of effective empirical testing on human subjects. One unexpected bonus that has come from the necessary reliance on animal testing though is the multitude of avenues of new research currently being investigated (Thayne et al., 2005).
Since 1995 investigation into techniques and tools to improve the efficacy of CPR as well as understanding the crucial elements which make the technique so useful in correcting dire heart has spurred huge advances in the understanding of hemodynamics as well as the pressures at work within the thoracic cavity (Lurie et al., 2008). This research has lead to the improved understanding of the importance not only of airways and breathing but also blood pressure and the profusion of organs has revolutionized the methods employed in life saving CPR as well as the development of more effective tools to aid those rescue efforts.
Cardiopulmonary Resuscitation techniques have been employed in life saving endeavors since the eighteenth century (Wiggins, 2005). The most groundbreaking research into the most efficacious manner implementing the chest compression and rescue breaths though has only occurred in the last fifteen years. Included in the discoveries are the necessity for the chst wall to recoil fully, the variability in the number of rescue breaths necessary between compressions, and even the benefits of potentially hypoventilating an individual experiencing cardiac arrest. CPR has become more effective, localized, and accurate and is thus one of the primary protocols in the emergency first response to medical crisis.
Cardiac arrest is an extremely dangerous medical event which results in a high number of fatalities despite the most advanced techniques and tools at emergency personnel's disposal. The ResQPOD though now infallible has been shown to be an effective method of improving the immediate efficacy of CPR manual chest compression in restoring a normative heartbeat. Also, unlike many other pieces of medical equipment the device is inexpensive and easy to understand and use (Rea et al., 2004). A time investment of just two hours has medical personnel proficient in the use of the device. Though by no means is this device an endpoint in research, it is an effective segue into the next generation of medical research regarding effective responses to cardiac arrest. As the American Heart Association suggests the ResQPOD should be implemented in all emergency personnel training and should be incorporated into the standard response for cardiac arrest.
1. Cooper, J. & Cooper, J. (2008). New stragtegies for cardio pulmonary resuscitation. Current Treatment Options in Cardiovascular Medicine, 10, 49 -- 58.
2. Rea, T., Eisenberg, S., Sinibaldi G, & White, D. (2004) Incidence of EMS-treated out-of-hospital cardiac arrest in the United States. Resuscitation, 63, 17 -- 24.
3. Thayne RC, Thomas DC, Neville JD, Van Dellen A. (2005). Use of an impedance threshold device improves short-term outcomes following out-of-hospital cardiac arrest. Resuscitation,67, 103-108
4. Wiggington, J. (2005). The inspiratory impedance threshold device for treatment of patients in cardiac arrest. Business Briefing: Long-Term Healthcare, 1-5.
5. Lurie, K., Yannopoulos, D., McKnite, S., Herman, M., Idris, A., Nadkarny, V., Tang, W., Gabrielli, A., Barnes, T., & Metzger, A. (2008). Ten vs. two breaths per minute in a…