The Napa Fire Department has equipped all six of its engines with automatic CPR machines, in hopes of reducing the role that human error can play when paramedics are treating a patient whose heart has stopped beating.
First responders can spend an hour performing CPR on some patients whose hearts have stopped beating. Their training tells them how to react to a moment like this — repeatedly press into the person’s chest at 1 ½ inches deep, at around 100 to 120 beats per minute, or the same tempo as “Stayin’ Alive” by the Bee Gees.
That can be hard to do, especially when a medic’s adrenaline is pumping and they’re getting tired, Napa Fire first responders say. Some Napa Fire personnel suffered back injuries after performing CPR for long periods of time.
Medics may have to pause to carry a patient down the stairs or let a less-fatigued colleague take over compressions, but researchers say frequent CPR interruptions can seriously hurt a patient’s chances of survival.
“Continuous CPR is what saves lives,” said Kurt Nylander, a firefighter paramedic. “Early CPR is probably the most important factor.”
During CPR, the blood in the body is like a train, said Napa Fire Captain Ty Becerra. When the train is stopped, it can take a while to get going again. That’s why the device’s ability to perform uninterrupted CPR is so important, he said.
Napa Fire got its first automatic CPR device, manufactured by LUCAS, about five years ago, then bought another two machines two years later, fire officials say. The department recently purchased another three LUCAS devices, for a total of six machines. The machines cost roughly $15,000 each.
That’s enough to equip an engine at each fire station with an automatic CPR machine. Napa Fire uses the machines on roughly two to four medical calls per week, Nylander said.
“We’re better equipped to service the community … and (provide) more of a rapid response,” Becerra said.
The LUCAS device comes in two pieces — a flat piece that slides under the patient’s back and a connecting piece shaped like an upside-down letter “U,” which hovers over the patient. In the middle of that “U” is a mechanical arm with a suction cup at the end.
Medics position that suction cup over the patient’s heart, and with the touch of a few buttons, it can deliver chest compressions at a steady pace and shock the heart like an AED. The negative pressure created by the suction cup fosters blood circulation in a way that people can’t when performing CPR, Nylander said.
LUCAS batteries last for about 30 to 40 minutes, and can be swapped out during a long series of chest compressions, officials say.
First responders were long taught that it was best to get a patient to the hospital as quickly as possible, Becerra said.
Research later showed that people have a better chance of recovering if they are treated on scene. Napa Fire medics have the tools to do anything that emergency room medics can do, Nylander said.
Though officials hope that the purchase of additional automatic CPR machines will make a difference in the quality of treatment that patients receive, Nylander said a patient’s chances of survival are much higher if bystanders begin performing hands-only CPR before first responders arrive.
Kevin Horn, a firefighter paramedic, conducts Napa Fire’s free hands-only CPR classes.
About 3 percent of patients in full cardiac arrest were making a total neurological recovery when Horn joined the department in 1995. Now the same is true for nearly a quarter of patients. In 2016, Napa County’s save rate was higher than anywhere else in the nation, he said.
The department has since offered CPR classes and recommended a smartphone app called PulsePoint, which directs users to the nearest AED.
“I think that’s why we’re seeing so much success in our save rates,” he said. “And honestly, I think it’s only going to go up.”
To schedule a hands-only CPR lesson with the fire department, email firstname.lastname@example.org.