CPR is hard and sometimes dangerous work.
As any experienced EMT will attest, the act of rhythmically, forcefully and properly pushing on a patient's bony chest plate - 100 times a minute to a depth of two inches - can be exhausting and all-consuming.
That's why paramedics typically rotate the duty every couple of minutes.
Add to that exercise the element of danger, which EMTs routinely experience while performing CPR in the back of a moving ambulance, unrestrained by any seat belts as the ambulance driver dodges the unpredictable moves of other, often unmindful, motorists.
"One of my biggest fears is being T-boned while we are going to the hospital," said Lt. Keith Eldard of the Helotes Fire Department's months-old EMS.
Now, thanks to a local health care benefactors, San Antonio and Helotes emergency medical crews will get a bit of a break from some of that exhaustion and peril in the form of a medical device that performs chest compressions automatically. Make that four of the devices.
The Nix Health Care Foundation announced Tuesday that it, with the support of the Alamo Medical Group, is donating four LUCAS Chest Compression Systems to the San Antonio and Helotes fire departments.
The donation marks the first time the fire departments will have these life-saving machines onboard its EMS ambulances.
The 2010 American Heart Association CPR Guidelines place increasing emphasis on the importance of chest compressions, recommending at least 100 compressions per minute, an exceedingly difficult task for an average person performing CPR.
The LUCAS system is designed to provide continuous, uninterrupted and effective chest compressions at the recommended rate, enabling rescuers to attend to other aspects of care.
The device is simple to use, taking only 20 seconds to apply externally to a patient and begin chest compressions. This new technology also has the potential to further increase the effectiveness of the fire department's highly-trained EMS personnel, allowing them to focus on other vital tasks of patient care, such as administering medication, ventilation and defibrillation.
"We believe this newly acquired technology will enable us to provide even better care for patients in cardiac arrest," said Dr. Craig Manifold, an osteopathic physician and medical director of the San Antonio Fire Department as well as several suburban city departments, including Helotes.
"This particular device will be a great tool for us if we have a patient to provide CPR to," said Helotes Fire/EMS Chief Walton Daugherty. "Right now, we have to do that manually, and it takes a person to provide those chest compressions (and) they get fatigued very quickly. This tool will provide that, and also at the proper depth for that patient.
"It will also free up that person to do other things, such as administer drugs or give the patient breaths. During transport, this device will allow our people administering care to be seat belted. It can be very dangerous if the paramedic is not seat-belted."
"If I was a betting man," Manifold offered, "hospitals will see how effective (the devices are) and ERs and cath labs will start purchasing these devices."
In the hospital, cath lab personnel can remain at a safe distance from X-ray exposure while the device provides mechanical chest compressions during cath lab procedures.
The Lucas system is in the neighborhood of $20,000, according to the company's sales representatives.
Each year, nearly 300,000 Americans experience SCA and most (95 percent) don't survive.
In practice for the past 50 years, CPR typically uses artificial respiration along with chest compressions to return a heart beat and/or breathing to victims of heart attacks or respiratory arrest.
But in 2010, the American Heart Association announced that it endorses the use of chest compressions alone - without artificial respiration - for adults who collapse suddenly in cardiac arrest.
CPR is an important way to keep a victim's organs alive immediately after a heart attack or another event where the worry is that a victim's blood will stop circulating and oxygen will not get to organs, particularly the brain. CPR provides oxygenated blood to the organs until further treatment can be carried out.
The brain can be damaged by a lack of oxygen in as little as four minutes, and can suffer irreversible damage after about seven minutes.
"For every minute without blood flow to your brain, there is a 10 percent reduction in survival," said Manifold.
For that reason, CPR is usually effective only if it's performed within seven minutes, and as quickly as possible, after a heart attack.
CPR provides 30 to 50 percent of the effective blood circulation of the heart, said Manifold, "enough to keep oxygen flowing through the brain and maintain survivability."