PHILIPS MEDICAL SYSTEMS
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ECPR FIRST CONFIGURATION
The CPR First parameter provides a tool for Medical Directors and
Administrators to implement existing or emerging protocols. Currently, some
emergency response protocols incorporate a CPR interval prior to applying the
AED. Although this provides for initial CPR treatment, since the device is not
attached to the patient it cannot collect data or provide the responder with
prompts or an initial CPR interval. Note that previous versions of the FR2+
could be attached for data collection during initial CPR, via an enabled Pause key.
Research has shown that some SCA patients − particularly those presenting
with low-amplitude, low-frequency VF rhythms typical of long down times − may
not benefit from an initial shock, and for these patients an interval of CPR prior
to defibrillation may improve outcome.
1-3
Accordingly, some Medical Directors may wish to configure the FR2+ to be able
to provide an initial CPR interval prior to defibrillation. Before making that
decision, the Medical Director should consider the overall impact the selected
setting would have on the SCA emergency response system, and train
responders accordingly. If a system-wide change is desirable, software upgrades
for existing FR2/FR2+ defibrillators are available from Philips. Other factors to
be considered include:
• Emergency system response times
• Responder skill level
• Prevailing protocols and time and cost for training
• Expected changes in response protocols
1 Wik L, Hansen TB, Fylling F, Steen T, Vaagenes P, Auestad B, Steen PA. Delaying
defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-
hospital ventricular fibrillation: a random trial. JAMA March 19, 2003. 289:11:1389-
1395.
2 Cobb LA, Fahrenbruch CE, Walsh TR, Copass MK, Olsufka M, Breskin M, Hallstrom
AP. The influence of cardiopulmonary resuscitation prior to defibrillation in patients
with out-of-hospital ventricular fibrillation. JAMA, April 7, 1999, 281:13:1182-1188.
3 Weisfeldt ML, Becker LB. Resuscitation after cardiac arrest: a 3-phase time-sensitive
model. JAMA, December 18, 2002. 288:23:3035-3038.
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