New Medical Device: Zoll R Series Defribillator

It's difficult for new medical devices to impress me. This one did.

One of the challenges in medicine is doing effective CPR. Research studies have consistently shown that what generally saves a patient's life is early and effective CPR. That's when all the other bells and whistles that we have in our medical stockpile will work.

However, you might be surprised at how ineffectively we do CPR. For one thing, it's physically hard to compress the chest enough to generate a pulse. Second, it's tough to measure the effectiveness of compressions. The way this is traditionally accomplished now is through palpating a pulse during CPR (which is difficult to do accurately) or to measure what's called end tidal CO2 which is best accomplished when a patient has a breathing tube down their trachea.

Another difficulty in doing CPR is the amount of artifact it creates. Artifact is something you see on the monitor that isn't a true representation of the patient's condition. For instance, if a patient is connected to a monitor and you pick up their ECG leads and shake them-- you can make it look like they're in a lethal cardiac rhythm.

If you're doing effective compressions, you can't see the patients underlying rhythm but stopping CPR to check a patient's rhythm takes away from its effectiveness as well. It takes a while to establish pulsatile flow with CPR so every time you stop, the patient can suffer.

The Zoll R Series Defibrillator attempts to change some of these issues and if it is able to do what it says-- it could mean a big improvement for patient care.

It has a pad that is placed at the center of the patient's chest. This measures the effectiveness of compressions and makes sure they are at the right rate and depth. It also allows you to see the patients underlying rhythm while compressions are ongoing which can lead to better treatment at the bedside when a rhythm changes.

It will be interesting to see if a device like this will decrease the morbidity and mortality around code events.

I was not paid by the company to review this product.