a b s t r a c t
Background: Minimizing the chest compression pause associated with application of a mechanical CPR
device is a key component of optimal integration into the overall resuscitation process. As part of a
multi-agency implementation project, Anchorage Fire Department deployed LUCAS CPR devices on BLS
and ALS fire apparatus for initiation early in resuscitation efforts. A 2012 report identified the pause
interval for device application as a key opportunity for quality improvement (QI). In early 2013 we began
a QI initiative to reduce device application time interval and optimize the overall CPR process. To assess
QI initiative effectiveness, we compared key CPR process metrics from before to during and after its
implementation.
Methods: We included all cases of EMS-treated out-of-hospital cardiac arrest during 2012 and 2013 in
which a mechanical CPR device was used and the defibrillator electronic record was available. Continuous
ECG and impedance data were analyzed to measure chest compression fraction, duration of the
pause from last manual to first mechanical compression, and duration of the longest overall pause in the