Lifepak (stylized LIFEPAK) is a series of vital signs monitors and external cardiac defibrillators produced by medical technology company Physio-Control. [1] [2] [3] [4]
In 2020 the company recalled some of its defibrillators after it learned they may fail in some circumstances, however the issues have been addressed. [5] [6]
Physio-Control publicly demonstrated its first Lifepak branded defibrillator, Lifepak 33, in November 1968 and began commercial sale of the unit the next year in 1969. [7] [8] The Lifepak 33 was the lightest defibrillator available at launch, weighing 34 pounds. The defibrillator was referred to by media as a "90-day wonder" due to the entirety of its development occurring within a 90-day period. Despite being the companies first "LIFEPAK" branded defibrillator, it was named the Lifepak 33 due to the companies target weight of 33 pounds for the defibrillator. [9]
In 1971, the Lifepak 911 was released with 12-lead ECG monitoring capability, with the Lifepak 2 being released the following year. The Lifepak 2 was designed specifically for rapid-response vehicles in emergency services, and was the first to allow transmission of ECGs via telephone to hospitals for prehospital assessment by cardiologists. In 1973, the Lifepak 3 was released with a "non-fade" display and the ability to "freeze" the cardioscope. The Lifepak 1 was released the same year and was marketed as a more basic, but more compact model, lacking a cardiograph for ECG monitoring. In 1974, the Lifepak 4 was released with an integrated ECG recorder, and was followed by the Physio 260 (for home use) and Physio 1440 cardiac care system defibrillators were released to the public. [9]
In 1976, the Lifepak 5 was released weighing only 5 pounds and 19 ounces, with a modified Lifepak 5 accompanying the 65-member American Medical Expedition to Mount Everest in 1981 and the China-Everest Expedition in 1982. The Lifepak 6 featured a modular design with removable paddles holder and ECG printer, the Lifepak 8 featured the ability to perform transchest external pacing, and the Lifepak 100 and 200 automatic advisor defibrillators were released with an Incorporated Shock Advisory System able to recognise shockable arrhythmias. in 1989, the Lifepak 9 and 10 both integrated a "Code Summary" record for documentation, featuring the ability to record times medication was administered, when shocks were delivered and how many shocks were delivered. [9]
In 1994, the Lifepak 11 was released, which set standards in prehospital 12-lead acquisition and transmission. In 1997, the Lifepak 500 was released as a public access defibrillator, and brought AEDs to the mainstream public. The following year, the Lifepak 12 was released, with improved monitoring and diagnostic capabilities, as well as a standardised button layout. Some ambulance services still use the Lifepak 12 due to its reliability and advanced capabilities. [9]
The current model, Lifepak 15, was released in 2008 and featured a more refined design, new colour scheme as well as colour display, CPR metronome and Bluetooth connectivity for wireless transmission of ECGs. [10]
Semi-automatic units include the Lifepak 12, Lifepak 15, and Lifepak 20 for use by healthcare professionals such as emergency medical technicians and paramedics. Automatic units include the Lifepak 500, Lifepak 1000, Lifepak CR Plus and the Lifepak CR2 for use by members of the public who have been trained to operate them. [11]
Most Lifepak defibrillators are capable of performing more than only defibrillation. Many models allow for cardiac monitoring (including heart rate monitoring and 12-Lead ECG acquisition and interpretation) and alert the users to sudden changes. The Lifepak 15 and 20e (when equipped with CodeManagement Module) include a CPR metronome that is also capable of verbally aiding rescuers in providing ventilations. Some Lifepak defibrillators also include options for synchronized cardioversion, external pacing, oxygen saturation monitoring, CO2 output monitoring, and both non-invasive and invasive blood pressure. [12] The Lifepak CR2 includes CPRInsight analysis technology which allows for chest compression during analysis of the patient's ECG. [13]
Cardiac arrest, also known as sudden cardiac arrest, is when the heart suddenly and unexpectedly stops beating. As a result, blood cannot properly circulate around and the body. One major consequence is that there is not enough blood flow to the brain and other organs. When the brain does not receive enough blood, this can cause a person to pass out and suddenly collapse. Additional symptoms of sudden cardiac arrest can include pulselessness and abnormal or absent breathing. Without emergent intervention, cardiac arrest can lead to death. Immediate interventions including cardiopulmonary resuscitation (CPR), and defibrillation improve survival outcomes.
Cardiopulmonary resuscitation (CPR) is an emergency procedure consisting of chest compressions often combined with artificial ventilation, or mouth to mouth in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. It is recommended for those who are unresponsive with no breathing or abnormal breathing, for example, agonal respirations.
Cardioversion is a medical procedure by which an abnormally fast heart rate (tachycardia) or other cardiac arrhythmia is converted to a normal rhythm using electricity or drugs. Synchronized electrical cardioversion uses a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle, restoring the activity of the electrical conduction system of the heart. Pharmacologic cardioversion, also called chemical cardioversion, uses antiarrhythmia medication instead of an electrical shock.
Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach). A defibrillator delivers a dose of electric current to the heart. Although not fully understood, this process depolarizes a large amount of the heart muscle, ending the arrhythmia. Subsequently, the body's natural pacemaker in the sinoatrial node of the heart is able to re-establish normal sinus rhythm. A heart which is in asystole (flatline) cannot be restarted by a defibrillator; it would be treated only by cardiopulmonary resuscitation (CPR) and medication, and then by cardioversion or defibrillation if it converts into a shockable rhythm.
An automated external defibrillator or automatic electronic defibrillator (AED) is a portable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation (VF) and pulseless ventricular tachycardia, and is able to treat them through defibrillation, the application of electricity which stops the arrhythmia, allowing the heart to re-establish an effective rhythm.
Basic life support (BLS) is a level of medical care which is used for patients with life-threatening illnesses or injuries until they can be given full medical care by advanced life support providers. It can be provided by trained medical personnel, such as emergency medical technicians, and by qualified bystanders.
Ventricular tachycardia is a cardiovascular disorder in which fast heart rate occurs in the ventricles of the heart. Although a few seconds of VT may not result in permanent problems, longer periods are dangerous; and multiple episodes over a short period of time are referred to as an electrical storm. Short periods may occur without symptoms, or present with lightheadedness, palpitations, or chest pain. Ventricular tachycardia may result in ventricular fibrillation (VF) and turn into cardiac arrest. This conversion of the VT into VF is called the degeneration of the VT. It is found initially in about 7% of people in cardiac arrest.
Advanced Life Support (ALS) is a set of life saving protocols and skills that extend basic life support to further support the circulation and provide an open airway and adequate ventilation (breathing).
A flatline is an electrical time sequence measurement that shows no activity and therefore, when represented, shows a flat line instead of a moving one. It almost always refers to either a flatlined electrocardiogram, where the heart shows no electrical activity (asystole), or to a flat electroencephalogram, in which the brain shows no electrical activity. Both of these specific cases are involved in various definitions of death.
Commotio cordis is a rare disruption of heart rhythm that occurs as a result of a blow to the area directly over the heart at a critical instant during the cycle of a heartbeat. The condition is 97% fatal if not treated within three minutes. This sudden rise in intracavitary pressure leads to disruption of normal heart electrical activity, followed instantly by ventricular fibrillation, complete disorganization of the heart's pumping function, and cardiac arrest. It is not caused by mechanical damage to the heart muscle or surrounding organs and is not the result of heart disease.
Transcutaneous pacing (TCP), also called external pacing, is a temporary means of pacing a patient's heart during a medical emergency. It should not be confused with defibrillation using a manual or automatic defibrillator, though some newer defibrillators can do both, and pads and an electrical stimulus to the heart are used in transcutaneous pacing and defibrillation. Transcutaneous pacing is accomplished by delivering pulses of electric current through the patient's chest, which stimulates the heart to contract.
The chain of survival refers to a series of actions that, properly executed, reduce the mortality associated with sudden cardiac arrest. Like any chain, the chain of survival is only as strong as its weakest link. The six interdependent links in the chain of survival are early recognition of sudden cardiac arrest and access to emergency medical care, early CPR, early defibrillation, early advanced cardiac life support, and physical and emotional recovery. The first three links in the chain can be performed by lay bystanders, while the second three links are designated to medical professionals. Currently, between 70 and 90% of cardiac arrest patients die before they reach the hospital. However, a cardiac arrest does not have to be lethal if bystanders can take the right steps immediately.
The history of cardiopulmonary resuscitation (CPR) can be traced as far back as the literary works of ancient Egypt. However, it was not until the 18th century that credible reports of cardiopulmonary resuscitation began to appear in the medical literature.
Pediatric advanced life support (PALS) is a course offered by the American Heart Association (AHA) for health care providers who take care of children and infants in the emergency room, critical care and intensive care units in the hospital, and out of hospital. The course teaches healthcare providers how to assess injured and sick children and recognize and treat respiratory distress/failure, shock, cardiac arrest, and arrhythmias.
Cardiac monitoring generally refers to continuous or intermittent monitoring of heart activity to assess a patient's condition relative to their cardiac rhythm. Cardiac monitoring is usually carried out using electrocardiography, which is a noninvasive process that records the heart's electrical activity and displays it in an electrocardiogram. It is different from hemodynamic monitoring, which monitors the pressure and flow of blood within the cardiovascular system. The two may be performed simultaneously on critical heart patients. Cardiac monitoring for ambulatory patients is known as ambulatory electrocardiography and uses a small, wearable device, such as a Holter monitor, wireless ambulatory ECG, or an implantable loop recorder. Data from a cardiac monitor can be transmitted to a distant monitoring station in a process known as telemetry or biotelemetry.
A wearable cardioverter defibrillator (WCD) is a non-invasive, external device for patients at risk of sudden cardiac arrest (SCA). It allows physicians time to assess their patient's arrhythmic risk and see if their ejection fraction improves before determining the next steps in patient care. It is a leased device. A summary of the device, its technology and indications was published in 2017 and reviewed by the EHRA Scientific Documents Committee.
Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a resting heart rate that is too slow – below 60 beats per minute – is called bradycardia. Some types of arrhythmias have no symptoms. Symptoms, when present, may include palpitations or feeling a pause between heartbeats. In more serious cases, there may be lightheadedness, passing out, shortness of breath, chest pain, or decreased level of consciousness. While most cases of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in sudden death.
Rearrest is a phenomenon that involves the resumption of a lethal cardiac dysrhythmia after successful return of spontaneous circulation (ROSC) has been achieved during the course of resuscitation. Survival to hospital discharge rates are as low as 7% for cardiac arrest in general and although treatable, rearrest may worsen these survival chances. Rearrest commonly occurs in the out-of-hospital setting under the treatment of health care providers.
Physio-Control was founded in 1955 by Dr. Karl William Edmark as a pioneering company in the field of portable defibrillation. Physio-Control manufactures emergency defibrillation and automated CPR equipment. The company was most recently acquired in 2016 by Stryker Corporation and is now part of Stryker's Emergency Care division.
Every year sudden cardiac arrest (SCA) kills between 35,000 and 45,000 people in Canada and approximately 350,000 people in the United States; 85% of SCAs are caused by ventricular fibrillation (VF). Receiving defibrillation from an automated external defibrillator (AED) is a key component of the 'chain of survival' for victims of SCA. Chances of survival from a SCA decrease by 7–10% every minute that a victim does not receive defibrillation. Attempts at reducing time until defibrillation have largely focused on improving traditional emergency medical service (EMS) responders and implementing publicly available defibrillator (PAD) programs. In the United States approximately 60% of SCAs are treated by EMS. Equipping police vehicles with AEDs and incorporating them in the emergency dispatching process when a SCA is suspected, can reduce the time until defibrillation for a victim suffering an out-of-hospital sudden cardiac arrest. There are numerous studies which confirm a strong coloration between equipping police vehicles with AEDs and reduced time until defibrillation which ultimately translates into improved survival rates from SCA. As a result of these demonstrable statistics, police departments across North America have begun equipping some or all of their police vehicles with AEDs.