During a patient transport with ongoing resuscitation, external mechanical compression devices may be a good alternative to manual compression because they increase the safety of the rescuer and patient. Yet, in this study only animax mono reached the guideline specifications regarding chest compressions' frequency and depth. Concerning constancy, the mechanical devices work reliably and more independently from motion influences. Further studies are necessary to evaluate the effectiveness of these devices in patient transport.

Mechanical chest compression devices are mentioned in the current guidelines of the European Resuscitation Council (ERC) as an alternative in long-lasting cardiopulmonary resuscitations (CPR) or during transport with ongoing CPR. We compared manual chest compression with mechanical devices in a rescue-helicopter-based scenario using a resuscitation manikin. Manual chest compression was compared with the mechanical devices LUCAS™ 2, AutoPulse™ and animax mono (10 series each) using the resuscitation manikin AmbuMan MegaCode Wireless, which was intubated endotracheally and controlled ventilated during the entire scenario. The scenario comprised the installation of each device, transport and loading phases, as well as a 10-min phase inside the helicopter (type BK 117). We investigated practicability as well as measured compression quality. All mechanical devices could be used readily in a BK 117 helicopter. The LUCAS 2 group was the only one that fulfilled all recommendations of the ERC (frequency 102 ± 0.1 min(-1), compression depth 54 ± 3 mm, hands-off time 2.5 ± 1.6 %). Performing adequate manual chest compression was barely possible (fraction of correct compressions 21 ± 15 %). In all four groups, the total hands-off time was <10 %. Performing manual chest compressions during rescue-helicopter transport is barely possible, and only of poor quality. If rescuers are experienced, mechanical chest compression devices could be good alternatives in this situation. We found that the LUCAS 2 system complied with all recommendations of ERC guidelines, and all three tested devices worked consistently during the entire scenario.

During military missions of the German Armed Forces there are no other options to perform resuscitation than by performing this procedure with only two rescuers. Using the algorithm in a modified way securing of the airway with an LT, the performance of over-the-head chest compressions and an effective resuscitation with advanced cardiac life support according to the ERC guidelines of 2005 are feasible even with 2 rescuers. Using the LT instead of endotracheal intubation to secure the airway particularly contributed to shortening the hands-off time.

High-quality chest compressions are crucial during resuscitation if a positive outcome is to be achieved. Sometimes a patient must be transported within the hospital while chest compressions are being performed. We compared different chest compression devices [animax mono (AM), AutoPulse(®) (AP) and LUCAS2™ (L2)] with manual chest compression using a manikin during transport from a fifth floor ward to the cardiac catheterization laboratory in the basement. Chest compressions were interrupted for 10.7 s to set up the AM, 15.3 s for the L2 and 23.5 s for the AP. The use of a mechanical device reduced transport times from 144.5 s when manual compressions were underway, to 126.8, 111.1 and 98.5 s with the AM, L2 and AP, respectively (p < 0.05). Transfer to the laboratory gurney required little or no interruption in chest compressions with the L2 (0.8 s) and AP (no interruption), compared with 10.3 s with the AP and 3.3 s for manual compressions. Manual compression frequency was 124 min(-1), compared with 100.4 min(-1) for the AM, 99.9 min(-1) for the L2 and 79.7 min(-1) for the AP. Compression depth did not change during transport in any group. Mechanical compression devices are suitable for use during transport, but are not clearly superior to manual compressions. Devices maintain the same compression depth, but fell short of current guidelines, as did manual compressions. Some interruptions occurred while the devices were set up. Further, patient studies are necessary to determine the clinical utility of these devices.

The emergency medical team should know about the function of the specific hydraulic rescue tools (?Jaws of Life?) ? Spreaders, Cutters and additional Rams ? of the fire services. The rescue procedure in autogas vehicle accidents is almost not different from the procedure in conventional vehicle accidents. Approaching electric/hybrid vehicle accidents, the rescue team has to avoid contact with the orange high voltage cable. The operational leadership in rescue procedures is regulated by the respective state law. In motor vehicle accidents, the teamwork between the fire department and the emergency medical service is very important for the successful rescue of the patients. Therefore, the emergency medical team should know about the technical skills for patient extrication.