Heads up CPR Study: Can It Serve as a Standard Emergency procedure for Human Cardiac Arrest?

Heads-up Animal-tested CPR is Not Ready for Out-of-clinic Human Cardiac Arrest Care. Find Out Why!

Medical leaders will need to conduct further heads up CPR study before adopting this new resuscitation technique that has been tested on animals.

While we have cases where medics and emergency safety providers may need to use some application of the of a heads-up CPR method, moderation and care must prevail because the idea of heads-up CPR is based entirely on animal studies.

There are no conclusive findings for the best way to implement this practice in an outside-the-clinic environment.

In the past, we’ve seen emergency safety providers have fallen for new life-saving gadgets that did not really deliver in life-threatening scenarios.

These past mistakes should ring loud bells to industry leaders to appreciate the importance of conducting official tests to thoroughly scrutinize any innovation or process before they include it in their service.

Scientific studies should entail a thorough and careful examination of the scientific literature. And because we are handling human lives, we have no room for blunders trying to implement unproven methods, like the heads-up Cardiopulmonary Resuscitation.

Heads-up CPR: What does it entail?

Ask most what is heads up CPR, and it would mean elevating the victim’s head, but medically, it isn’t just about that. Animal studies have brought more insights into heads-up CPR. Here’s the order of implementation that emerged from the animal tests:

  • To begin with, the victim should be placed in a supine position, chest compressions administered with the help of an impedance-threshold-device (ITD) and continuous compression/ decompression (ACD) Cardiopulmonary Resuscitation.
  • Next, ACD-CPR + ITD should be applied for 2 minutes in the same body posture (supine) to boost up brain blood flow.
  • Lastly, the head and thorax of the victim should be lifted slowly, 30 degrees, step by step.

During implementation, researches demonstrated twice as much increase in cardiocerebral blood flow in the supine posture in animals alone.

Furthermore, there are many ways to execute the process; the rescuer can either use ACD-CPR + ITD or apply mechanical CPR (using a piston or band chest compression device) + ITD with some form of head- chest-up.

And while all these variations (as tested in animals) have reported an increase in brain blood flow in the supine position, none of them have been tested on humans.

What Emergency Safety Leaders Should do Before Adding a New cardiac Arrest Process

At the least, safety leaders should adhere to the following guidelines before adopting any new cardiac arrest process or device:

  • Develop a system to gather cardiac arrest data per the Utstein Resuscitation Registry Guidelines for Outside-hospital Cardiac Arrest.
  • Alternatively, and even better; they should be proactive in the Cardiac Arrest Registry to Enhance Survival or CARES. That way, they can learn how accurate and useful their procedures are and decide on the improvements to make. We can also ascertain that no harm is caused when applying the new technique.
  • EMS heads should also look at the chain of survival, particularly the components it impacts most.
  • Today CPR. Bystanders perform hands-only CPR.              

Lastly, they should also note that there will be a need for continuous training to maintain and better the execution of this new CPR approach.

The Verdict on Heads-Up CPR Protocol

Much of the research on the heads-up CPR protocol has been conducted with pig models with one study using a human manikin model.

Other similar studies looked at the use of ITD with ACD-CPR or ITD with piston-type mechanical CPR with but did not include elevation of the head.

Scientifically speaking, the above studies are not well-designed to allow the use of this approach in outside-hospital CPR. No wonder emergency safety providers should wait for more conclusive findings before standardizing heads-up CPR as a safety procedure:

Final note

In essence, there are no apparent effects or miracles in elevating the head of a victim in cardiac arrest.  Accepting a concept that has been proven on animals is the scientific road to finding out the truth after more thorough studies and not a shortcut to implementing untested practices.

It is crystal clear that supporters or advocates need to explore heads-up CPR further and come up with more reasons we should include it as an emergency procedure.