Stryker LUCAS 3 - User Manual

Standard Operating Procedure
SITE: Southern Illinois Healthcare
EFFECTIVE DATE: 4/22/2020
SUBJECT: LUCAS 3 application and usage
REVISION DATE:
DOCUMENT NUMBER:
LOCATION OF TEMPLATE:
AUTHORIZED BY: Tressa Furlow MSN,RN
DATE: 4/22/2020
SOP OWNER: Garrett Burton, System Director of Emergency
1 | P a g e
PURPOSE: The LUCAS 3 device is intended for use and an adjunct to manual CPR on adult patients who develop cardiac
arrest where effective manual CPR is compromised.
SCOPE:
ASSOCIATED DOCUMENTS & PROCEDURES:
DEFINITIONS:
PROCEDURE: LUCAS 3 Application and Usage
Activity / Task
1
Contraindications:
 Patient is too small
 Patient is too large
 Patient is a child
 Patient is pregnant
 Visible traumatic injury to the chest
2
Side Effects or Complications of use:
 Rib fractures
 Skin abrasions, bruising and chest soreness and possible injury to other organs
3
Benefits:
 LUCAS works by pressing down very quickly on the rib cage and holding it down for 50% of the period/ cycle.
 The device maintains consistent chest compression over a long period of time.
 One person becomes free to provide other care
4
Control Panel Keys:
1. POWER Key; green circle- when pushed for one second. The device will power up, an audible signal sequence is
heard and device automatically does a self-test. When self-test is complete, the audible signal stops and a green LED
light beside the ADJUST key illuminates. The self-test takes 3 seconds.
2. ADJUST key; use to adjust position of the suction cup. When pushed you can manually move the suction cup up or
down.
 To set Start position, manually push the suction cup down onto the patient’s chest.
 To remove, manually lift the suction cup and pull it up.
3. PAUSE key; When pause is pushed after adjusting the Suction Cup to the chest, the height position is fine-tuned and
locked into the START position. When pushed during compressions, the LUCAS will stop compressions and lock the
suction cup in its start position.
4. ACTIVE key; (Continuous) When this key is pushed, LUCAS performs continuous chest compressions. The green
LED signal will blink 10times/min to alert for ventilation during ongoing compressions. The second ACTIVE key is the
(30:2 when this key is pushed, the LUCAS performs 30 chest compressions and then temporarily stops to allow for 2
ventilations. An intermittent LED combination with an audible signal alerts the operator before each ventilation pause.
5
Arrival at the Patient:
 Confirm Cardiac Arrest and need for resuscitation. START high quality manual CPR.
 Apply ECG Defibrillator pads using real time CPR feedback technology; pay special attention not to
place the pads where the LUCAS Suction cup will be placed.
 Check rhythm every 2 minutes and defibrillate per AHA/ ACLS standards
 Zoll CPR feedback device stays in place throughout resuscitation regardless of CPR method.

Summary

LUCAS 3 Application and Usage Procedure

Contraindications for LUCAS 3 Use

Lists conditions where the LUCAS 3 device should not be used, such as patient size or pregnancy.

Side Effects or Complications

Details potential adverse effects like rib fractures or skin abrasions from device use.

Benefits of LUCAS 3 Device

Highlights advantages of the LUCAS device, including consistent compressions and freeing up personnel.

Control Panel Keys and Functions

Explains the function of the POWER, ADJUST, PAUSE, and ACTIVE keys on the LUCAS device.

Arrival at Patient and Initial Steps

Outlines initial steps upon arriving at a patient requiring resuscitation with the LUCAS device.

LUCAS 3 Device Setup and Operation

Unpacking and Device Readiness

Procedure for unpacking the LUCAS device and initiating its self-test for readiness.

Back Plate and Device Assembly

Steps for positioning the back plate, hood, and suction cup for correct device placement.

Initiating Mechanical Compressions

Instructions on using the ACTIVE keys to start continuous or 30:2 compressions.

Stabilization Strap Application

Guidance on correctly attaching and tightening the stabilization strap for the LUCAS device.

Defibrillation with LUCAS Device

Protocol for defibrillation while the LUCAS device is active, emphasizing minimal pause.

Patient Transport and Documentation

Transporting or Moving the Patient

Guidelines for moving patients with the LUCAS device attached, including safety precautions.

Documentation Requirements

Instructions for documenting LUCAS device use in EPIC, including adverse effects.

Overview

1. Function Description
2. Usage Features
3. Maintenance Features

The LUCAS 3 device is an automated chest compression system designed to provide consistent and effective cardiopulmonary resuscitation (CPR) to adult patients experiencing cardiac arrest, particularly when manual CPR is compromised or prolonged. It serves as an adjunct to manual CPR, ensuring high-quality compressions are maintained throughout the resuscitation effort.

Function Description

The core function of the LUCAS 3 device is to deliver mechanical chest compressions. It operates by pressing down rapidly on the rib cage and maintaining a compression depth for 50% of the compression cycle. This mechanism ensures consistent compression depth and rate, which are critical for effective blood circulation during cardiac arrest. The device is capable of performing continuous chest compressions or compressions with pauses for ventilation, adhering to either a continuous compression protocol or a 30:2 compression-to-ventilation ratio, as selected by the operator.

The device's control panel features several key functions. The POWER Key initiates the device, triggering an audible signal sequence and a self-test that takes approximately three seconds. Upon completion, a green LED illuminates next to the ADJUST key, indicating readiness. The ADJUST key is crucial for positioning the suction cup on the patient's chest. It allows for manual movement of the suction cup up or down. To set the initial compression position, the suction cup is manually pushed down onto the patient's chest. For removal, it is lifted up. The PAUSE key serves two purposes: when pressed after initial suction cup adjustment, it fine-tunes and locks the height position into the START position. During active compressions, pressing the PAUSE key stops compressions and locks the suction cup in its current start position. The ACTIVE key has two modes: one for continuous chest compressions, where a green LED blinks 10 times per minute to signal the need for ventilation, and another for a 30:2 compression-to-ventilation ratio, where the device performs 30 compressions and then temporarily stops for two ventilations, with an intermittent LED and audible signal preceding each pause.

Usage Features

The LUCAS 3 device is designed for ease of application and integration into existing resuscitation protocols. Upon arrival at the patient, manual CPR should be initiated immediately, and ECG defibrillator pads with real-time CPR feedback technology should be applied, ensuring they do not interfere with the LUCAS suction cup placement. Rhythm checks and defibrillation should follow AHA/ACLS standards, with the Zoll CPR feedback device remaining in place throughout the resuscitation.

Unpacking the device involves pressing the ON/OFF button for one second to initiate the self-test. The back plate is positioned at the patient's head while manual CPR continues. To place the back plate, one team member supports the patient's head and shoulders, while another slides the back plate behind the patient's shoulders, ensuring it is correctly positioned below the armpits with the patient's arms outside the plate. The upper part (hood) is then attached to the back plate, with support legs securely locked. The suction cup is set to ADJUST mode and precisely positioned on the patient's chest, aligning with the manual CPR compression point. The lower edge of the suction cup should be immediately above the end of the sternum, and this landmark should be marked with a permanent or skin marker for future reference. If the suction cup is not correctly positioned, the ADJUST function allows for repositioning by pulling on the support legs. Once correctly positioned, the device will adjust the suction cup to the correct START position if it was pushed too hard or too loosely.

Mechanical compressions are initiated by pressing either the ACTIVE (continuous) or ACTIVE (30:2) key. It is crucial that the patient and device are not left unattended while LUCAS is active, and the device's performance (compression vs. frequency and depth) should be checked. To stop compressions, the PAUSE key is pressed.

For patient stabilization, a neck strap from the carrying case is used. It is extended, and a cushion is placed behind the neck. The buckles on the support leg straps are connected to the neck strap, ensuring they are not twisted. The LUCAS support legs are held stable while tightening the neck strap, and the suction cup position is re-verified.

Defibrillation can be performed without pausing compressions with the LUCAS device. If a shockable rhythm is identified, defibrillation is performed per ACLS protocol, with compressions paused for less than 5 seconds only to check the rhythm, and then resumed by LUCAS.

The LUCAS device allows for compressions to continue while the patient is being moved or transported. When preparing to move the patient, the patient's arms are secured at the wrist with the PATIENT STRAPS to the LUCAS hood. These straps are solely for fixating the patient's arms to the device and should not be used for lifting. A caution is noted regarding potential skin burns if the LUCAS hood and battery temperature exceed 118°F (48°C), advising to avoid prolonged contact and remove patient hands from straps to prevent burns.

Maintenance Features

While the document does not explicitly detail maintenance features in a dedicated section, it implies certain operational checks and considerations that contribute to the device's reliable function. The self-test initiated upon powering on the device is a built-in diagnostic feature, ensuring the device is ready for use. The instruction to "Check that device is working as should- compression vs. frequency and depth" during active use suggests an ongoing monitoring aspect, which can help identify any deviations in performance. The emphasis on correct positioning of the suction cup and the device's ability to adjust to the correct START position if initially pushed too hard or too loose indicates a design that aims to prevent misuse and ensure optimal operation, thereby contributing to the longevity and effectiveness of the device. The documentation requirements, including noting any evidence of patient adverse effects such as skin breakdown, suggested fracture, or chest deformity, serve as a feedback mechanism that can inform future device improvements or maintenance protocols. The reminder to submit data to the Zoll Cloud after each Code Blue suggests a system for data collection that could be used for performance analysis and potentially for predictive maintenance or fleet management.

Stryker LUCAS 3 Specifications