Does the LUCAS improve outcomes?
No. The authors state that clearly.
Do people think that we should use the LUCAS anyway?
Yes. The excuses are presented by many people.
What are the possible benefits?
1. The LUCAS allows us to free up a pair of hands to do other things that do not benefit the patient, so this adds nothing useful.
2. The LUCAS allows us to transport the patient safely. This is a rehash of #1, since routine transport does not improve outcomes.
3. Treatment will be consistent, regardless of the quality of the EMS. Rather than improve quality, we will have a machine take over something we think is done poorly, so that EMS can harm the patient by doing other things poorly.
4. The LUCAS can take over one of the two treatments that can improve outcomes. An AED can take over the other. We no longer need to have EMS respond to cardiac arrest calls until after ROSC (Return Of Spontaneous Circulation).
If the dramatic success of Seattle is due mostly to the frequency of bystander CPR, that would suggest that the best use of the LUCAS is in the hands of bystanders, not EMS.
If that is too much adult material, we can do the version for kids.
Or we can do the version for toddlers.
If EMS cannot manage that, should we be giving them equipment to free them up to mess up intubation or drugs or other things that do not improve outcomes.
Why are we so eager to add treatments that do not help patients?
Ethical patient care means limiting ourselves to treatments that improve outcomes.
Dr. Brooks Walsh also explains the failure of the LUCAS in this study in “We had a LUCAS save!” – No, you didn’t.
Also see -
 Mechanical chest compressions and simultaneous defibrillation vs conventional cardiopulmonary resuscitation in out-of-hospital cardiac arrest: the LINC randomized trial.
Rubertsson S, Lindgren E, Smekal D, Östlund O, Silfverstolpe J, Lichtveld RA, Boomars R, Ahlstedt B, Skoog G, Kastberg R, Halliwell D, Box M, Herlitz J, Karlsten R.
JAMA. 2014 Jan 1;311(1):53-61. doi: 10.1001/jama.2013.282538.
PMID: 24240611 [PubMed - indexed for MEDLINE]
The current sample size has a 95% confidence interval for the 4-hour survival ranging from −3.3% to +3.2%. Translated another way, while the point estimate for treatment effect was near 0.0, our study could not rule out the possibility of a 3.2% benefit or a similarly sized harm from mechanical CPR relative to standard CPR.
Not just not helpful, but this could be harmful.