Philips in CPR

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Philips Resuscitation Technology Solutions• Our goal is to relate Philips in CPR

directly to the 2005 AHA guidelines

– Quick Shock– SMART CPR– Q-CPRTM

Quick ShockOnly from Philips

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AHA Guidelines 2005

• Effective chest compressions are essential for providing blood flow during CPR

• Blood flow delivers small but critical amount of oxygen to brain and myocardium

• CPR increases the likelihood that a shock will be successful (i.e. will terminate VF and the heart will resume an effective rhythm and perfusion)

• When shock is indicated, it is critical it be delivered as soon as possible after chest compressions are stopped

• Reduction in interval between compressions and shock delivery by as little as 15 seconds can increase predicted shock success

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What is Quick Shock?

• Ability to deliver a shock in less than 10 seconds after CPR pause

• Unique feature offered only on Philips AEDs

• Available on all HeartStart OnSite, FRx and FR2+ AEDs

• Competitive devices take between 13 and 27 seconds to deliver a shock

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HeartStart FR2+ 9.98s

100%

80%

60%

20%

5 10 15 20 2500%

Survival

Time to shockin seconds afterCPR is stopped

40%

30

Survival data: Swine; 7 minutes of VF

Yu T, et al. Circulation. 2002; 106:368-372

Survival Linked to Speed of Shock Delivery After CPR

Times measured from end of Stop-CPR prompt, with AEDs at maximum energy

HeartStart HS1 & FRx8.1s & 8.4s

7Cardiac Science G3 & Zoll AED+

MedtronicLP500

HeartStart FR2+ 9.98s

100%

80%

60%

20%

5 10 15 20 2500%

Survival

Time to shockin seconds afterCPR is stopped

40%

30

DefibtechLifeline

Medtronic CR+ & Welch AllynAED20

Medtronic CR+ Auto

Times measured from end of Stop-CPR prompt, with AEDs at maximum energy

Cardiac Science G3 Auto

Survival Linked to Speed of Shock Delivery After CPR

Survival data: Swine; 7 minutes of VF Yu T, et al. Circulation. 2002; 106:368-372

HeartStart HS1 & FRx8.1s & 8.4s

Welch AllynAED10

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Why is Quick Shock Important?

• Relates directly back to the guidelines; a reduction in interval between end of compressions and shock delivery can increase predicted shock success

• Using Philips AEDs with Quick Shock, the chance of survival is 80% or higher

• In 8 out of 9 competitive AEDs, survival rate is 40% or lower

SMART CPROnly from Philips

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AHA Guidelines 2005

• Recommend EMS providers consider CPR before shock for un-witnessed events, particularly when arrival time is > 4-5 minutes

• When EMS call-to-arrival time > 4-5 minutes, victims who receive 1½ – 2 minutes CPR before defibrillation showed increased survival rates compared with those who received immediate defibrillation:– An increase in survival due to initial resuscitation– An increase in survival-to-hospital discharge– An increase in 1 year survival rate

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Defibrillating VF Doesn’t Always Restore Circulation• A patient with a coarse, spiky

rhythm typical of short-duration VF may still have an energetic heart & may benefit from an immediate shock

• A patient with a weaker, flatter rhythm typical of long-duration VF has a depleted heart and is unlikely to return to circulation with a shock

• Other contributors besides VF duration: Diseased heart, cause of arrest

– CPR first showed improved survival rates

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What is SMART CPR?

• Technology that analyzes the patient’s rhythm for you and determines whether to shock first or perform CPR first

• Reinforces Guidelines 2005 recommendation of CPR before shock for un-witnessed events, particularly when arrival time is > 4-5 minutes

• Takes the guesswork out of determining length of victim downtime especially for un-witnessed events

• Available only on the Philips HeartStart FR2+

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Why is SMART CPR Important?The Survival Curve

0 1 2 3 4 5 6 7 8 9 10

50

40

30

20

10

0

Ambulance Response Time (Minutes)

Probability Of Survival

(%) CPR first

Wik, et al. JAMA, 2003, 289;1389-1395

Shock first (traditional AED behavior)

At 4+ minutes of downtime, chance of survival decreases with traditional shock first therapy

Q-CPRTM

Only from Philips

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AHA Guidelines 2005

• Methods needed to improve quality of CPR• Increased emphasis on importance of chest

compressions - “push hard, push fast”• Components of quality CPR include ventilation

rate & duration, compression depth, compression rate & number, complete chest recoil, and hands-off time

• Hyperventilation, including too many breaths or too large a volume, diminishes cardiac output and survival

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What is Q-CPR?

• Q-CPR is the first and only CPR measurement and feedback tool integrated into an ALS monitor/defibrillator

• Q-CPR promotes high-quality CPR delivery

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Why is Q-CPR Important?

• Q-CPR measures the exact items specified by the AHA Guidelines

Compressions:• Compression depth• Compression rate• Leaning (incomplete release)• Duty cycle (duration )• No flow time (inactivity timer) Ventilations:• Volume low• Frequency high or low• Inflation time fast or slow

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Philips Resuscitation Technology Solutions… Leading the Way

• Quick Shock on all HeartStart AEDs• SMART CPR for trained first responders • Q-CPR; CPR Measurement and Feedback for

ALS professionals