Broschüre Synchronisation EN

TEAMWORK TO PERFECTION SYNCHRONISATION OF CORPULS3 AND CORPULS CPR We have had this vision for a long time: The perfect interaction Thanks to the synchronized therapy, stress amongst the between corpuls3 and corpuls cpr during resuscitation. team can be significantly reduced. corpuls3 and corpuls cpr Raising the resuscitation processes to the next level of quality become one and when integrated into the team, this duo was our goal. makes resuscitation even more efficient. With its revolutionary modular design, the corpuls3 stands Hands-off time is significantly reduced* and the patient's out from other compact devices. It can be separated into chance of survival is increased – even under the most difficult the Monitoring Unit, Patient Box and Defibrillator/Pacer. conditions where space is at a premium. SPECIFICATIONS CORPULS3 • Weight: only 6.5 kg (SLIM, basic configuration) • Transflective 8.4’’ Display, with opt. touch screen • Extremely high dust and splash protection (IP55) • Control of the corpuls cpr via Bluetooth • Operation range: –20 °C to +55 °C • Integrated 4G modem and WLAN (basic functions: ECG monitoring, defibrillation) or LAN connection for data • DIN EN 1789 transfer/telemedicine • Aviation Standard RTCA DO 160 G • ECGmax and CEB® – the 22-lead • US Military Standard MIL-STD-810G ECG solution from corpuls * Refer to the chapter "Abstract Study"

F O C U S - O N - P A T I E N T S When designing the corpuls cpr, we focused on two things: A seamless rescue chain from pre-clinical, to air rescue to hospital, as well as the shortest possible hands-off time. This is the reason why the corpuls cpr arm can be aligned and fixed over the patient with just one movement in just a few seconds. During the therapy the corpuls cpr checks the position of the stamp after each ventilation break or after 100 compressions when in continuous mode. If the thorax has collapsed, the corpuls cpr automatically corrects the distance between the stamp and the thorax. Thus ensuring that the set compression depth is always achieved. With the three different boards made of radiolucent carbon, the user is optimally equipped for every mission. The synchronization makes the corpuls cpr the fourth module of the corpuls3 and rings us one step closer to our goal of a perfect rescue chain. Monitor Patient Box Defibrillator/ Mechanical Pacer Chest Compression SPECIFICATIONS corpuls cpr • Weight: 5.5 kg (arm with battery and stamp) • Customizable therapy parameters • Compression depth: 2–6 cm Frequency: 80–120/ min • • Therapy mode: 30:2 | 15:2 | continuous • Bluetooth and NFC • • Battery running time: up to 90 min Radiolucent boards • Quick & safe adjustment • Treatment of children from 8 years • Intuitive user interface: Therapy start/stop of age, pregnant women and obese key with alarm and 4 softkeys patients possible Children Pregnant Obese

CONNECTION IN 3 CLICKS During synchronized therapy, the corpuls3 is not just the the rescue team the ability to treat the patient in accordance remote control for the corpuls cpr - although that is also with the current guideline recommendations. The corpuls3 possible. The corpuls cpr has been perfectly integrated into shows all the required information on its display. the AED and manual mode of the corpuls3. Therefore giving Connect Start/Stop mCPR Cont. CPR Connect key to connect with the corpuls cpr via Bluetooth Bluetooth symbol symbolizes a Bluetooth connection to the corpuls cpr Pie chart with corpuls cpr symbol indicates a connection with the corpuls cpr and shows the 2 minute resuscitation cycle Start/Stop key to start and stop the mechanical chest compressions by the corpuls cpr Reset the time in the pie chart, if not defibrillated FULL CONTROL – AT ANY TIME Once connected to each other, it is no longer necessary to mode. All of the corpuls cpr therapy parameters are to operate the corpuls cpr during a resuscitation. The displayed on the monitor of the corpuls3. corpuls cpr is completely automatically controlled by the is completely automatically controlled by the If you would like to change the settings manually or stop or , regardless of whether it is in AED or manual corpuls3, regardless of whether it is in AED or manual start the corpuls cpr, this is also possible.

F O C U S - O N - P A T I E N T S INTELLIGENT CONTROL WITH THE CORPULS3 The intelligent control of the corpuls cpr by the corpuls3 during the corpuls3 as the central operating unit. The user only needs a resuscitation follows the current guideline recommendations to monitor the correct position of the stamp on the corpuls cpr. - depending on the mode (AED, Manual-ERC, Manual-AHA). All control commands for the user take place wirelessly between In each of the modes, the entire rhythm analysis is controlled via corpuls3 and corpuls cpr. STARTING SITUATION: The corpuls cpr is positioned on the patient and is performing chest compressions. There is a Bluetooth connection to a corpuls3. AED MODE 1. Analyse key interrupts the corpuls cpr for the AED analysis and then automatically continues the therapy by corpuls cpr. 2. If the rhythm is shockable, the defibrillator is charged and automatic preShock CPR is performed. 3. The Shock key interrupts the corpuls cpr for shock delivery. 4. If the rhythm is not shockable, the corpuls cpr therapy is automatically continued. MANUAL 1 (procedure according to ERC) 1. The stop mCPR key on the corpuls3 interrupts the corpuls cpr for manual rhythm control. 2. The Start mCPR key resumes chest compressions/ preS hock CPR. 3. If the rhythm is shockable, the Shock key interrupts the corpuls cpr for shock delivery. If the rhythm is not shockable, the Start mCPR key continues the therapy by the corpuls cpr. MANUAL 2 (procedure according to AHA) 1. Charge key loads the defibrillator. 2. The Stop mCPR key on corpuls3 interrupts the corpuls cpr for manual rhythm control. 3. If the rhythm is shockable, the Shock key interrupts the corpuls cpr for shock delivery. 4. Start mCPR key resumes the therapy by the corpuls cpr. 1 Analyse autom. Analyse 4 3 2 Charge preShock CPR 1 2 manuelle Analyse 3 Charge Charge Preshock CPR Charge 1 Charge 2 3 4 Loading manuelle Analyse

F O C U S - O N - P A T I E N T S Whether in a stairwell, on an aerial ladder or in alpine terrain, access to operate the corpuls cpr is often restricted. With the synchronized therapy, the stretcher being out of reach is no longer a problem. The user always has an overview of all values and can react immediately. In air rescue, patient access is extremely limited, and rescuers are belted into their seats. Thanks to the perfect interaction of the corpuls3 with the corpuls cpr, movement within the cabin can be reduced. The emergency physician can now treat the patient with mechanical chest compression alone, without having to accept long hands-off times. Urgent transport always carries high r isk for the patient and the rescue team – especially if the team must work while standing. Thanks to the synchronized therapy, the emergency team can remain buckled up while driving. Rhythm control and shock delivery can be performed on the corpuls3 while the rescuer is seated.

F O C U S - O N - P A T I E N T S In emergency situations there are often very few staff available. The intuitive connection of corpuls3 and corpuls cpr frees up the emergency team considerably. The physicians and nurses are available for other critical interventions, for example for airway management or medication administration. The Emergency Room can get hectic and overcrowded very quickly. The synchronized therapy relieves the team leaving them to concentrate on optimal treatment and therapy measures. For longer handovers, the corpuls3 starts the rhythm control automatically in AED mode and reminds the user to perform defibrillation. In the event of a possible radiation exposure, the corpuls cpr can remain on site and be controlled by the corpuls3 from a safe distance. The corpuls cpr radiolucent boards and the fact that the corpuls3 can be divided into its three modules, make both devices ideal partners in the cardiac Cath Lab, for example. With the synchronized therapy, there is no need to intervene in the sterile operating room.

PRESENTATION OF THE CPR SYNCHRONIZATION AT THE CIS 2020 Corpuls has been a leader in innovative medical technology for years. Even during the coronavirus pandemic, our company from southern Germany has come up with unique ideas – such as a panel discussion about new innovations, produced in-house and streamed live. An interview by Managing Director Dr. Christian Klimmer from this discussion: What was the idea behind synchronized therapy? usability studies were required. It just takes a little longer When developing the corpuls cpr, we already had the in this regulated field we are in. vision of connecting the device to the corpuls3 via Blue- tooth. We knew from the corpuls3 that fundamentally What do you think the five biggest advantages of this would be possible and safe. The possibilities were synchronizing the corpuls3 with the corpuls cpr are? obvious from the beginning: The top priority was an It's a shame that I can only mention five advantages, almost automated and synchronized resuscitation through because I actually see a lot more. But let me get started. the intelligent interaction of these two devices. First: The hands-off time during resuscitation is signifi- cantly reduced. Second: The synchronization frees up time The corpuls cpr has been on the market for a while. and resources for the rescuers, which can be used for Why did it take so long to implement this new feature? other purposes. Third: There is only one user interface for At the time of product launch, the corpuls cpr set new the user. This reduces the potential for error and the user standards in mechanical resuscitation and it was extre- has full control over the two devices at all times. Fourth: mely challenging in development. We are very proud that As the corpuls cpr also transmits all the mission data to we mastered those various challenges. However, in order the corpuls3, a data record is created for debriefing that to synchronize the two devices, extensive feasibility and comprehensively shows all aspects of the mission. In turn

improving the quality of subsequent missions. Fifth: I also see an improvement in the occupational safety of the users, especially when transporting the patient in a vehicle. The removable monitor allows the corpuls cpr to F A Q CPR be controlled remotely, without the user having to take Which software version do I need for the off their seat belt. synchronized therapy? Do you think synchronized therapy will be adopted Any corpuls3 that already has software version by the market? 4.0 has the feature on board. The corpuls cpr Yes. I'm very sure of that. Ever since we first introduced is compatible from software version 1.2. Older the corpuls cpr we have been asked whether it can be devices can be upgraded of course. connected to the corpuls3. We are convinced that with this new function, we can now offer all the customers Do I need training to be able to use the who wanted this connection all the options that they new functions? had in mind. As always, the operation is very intuitive, but trai- How have you reacted to the coronavirus pandemic? ning is mandatory. Synchronized therapy must not Fortunately, we had an IT structure from the beginning be used without the instruction from Application that made it possible for employees to immediately start Specialists or our partners. working from their homes. Our manufacturing depart- ment has achieved incredible things and built devices Is my corpuls3/corpuls cpr Bluetooth from early in the morning until late at night so that we compatible? Can my corpuls3 be retrofitted? could fulfill all orders asap. We also have a comprehen- sive hygiene concept for the employees in the office. Yes, all our devices are compatible. The corpuls cpr Bluetooth function can be How did you carry out the shock synchronization activated. If the corpuls3 does not have Blue- study under these circumstances? tooth, this function must be retrofitted. That was definitely a problem. Due to the social distancing restrictions and lock-down measures, we were unable to What happens if the connection is lost? conduct the study with our partner in Munich as planned. But we are fortunate that we could fall back on the If both devices lose their connection, the around 50 employees with (emergency) medical training corpuls cpr continues the current therapy and within our company. The previously mentioned hygiene the connection can be re-established. It is also concept made it possible to carry out the shock synchro- no problem to operate another corpuls device nization study here in house. nearby. WHAT IS "CIS"? corpuls presents the latest developments to sales partners and the public at the corpuls innova- tion summit (CIS). This year however, due to the coronavirus pandemic, the event took place as a worldwide streaming event. Customers and those interested were able to tune in live to see the Does shock synchronization cost anything? No, there are no additional costs after set up. What therapy parameters can be set by the corpuls3? new products in action and ask the developers All the parameters that are adjustable on the questions directly. corpuls cpr can be set by the corpuls3.

DATA ALWAYS IN VIEW With the combination of corpuls.manager, the management software solution for corpuls devices, follow-up becomes child's play. corpuls3 automatically SD-Karte manually In REVIEW by corpuls.manager you can clearly see that when the shock key is pressed, the corpuls cpr automatically stops, the shock is triggered and then the CPR is automatically continued. With just a few clicks, all curves of the corpuls3 (e.g. ECG, both devices occurs completely automatically in the corpuls3 CO2 or IBP) can be visually represented on a computer as soon as the device connects to the corpuls cpr. When the together with the corpuls cpr compression data. Thus, corpuls3 establishes a connection to the corpuls.manager past missions can be analysed and future operations can be server via cellular network or WLAN, the mission data is optimized. corpuls.manager enables an overall picture of automatically uploaded. one or more resuscitation missions in unprecedented detail, Then, in corpuls.manager you can specifically filter for rele- without much effort. Users who already work with corpuls. vant missions and carry out statistical analysis based on your manager or its predecessor corpuls.web REVIEW will not needs. need any adjustment period. The merging of the data from GUIDELINE BASED Guidelines have become an indispensable part of modern medicine. We have aligned the synchronization between corpuls3 and corpuls cpr to the basis of the current guideline recommendations according to Monsieurs et al. 2015, as high-quality chest compressions increase the patient's chance of survival: • At least 5 cm compression depth (maximum 6 cm) • The chest compressions should only be minimally • Compression rate of 100-120 compressions/min interrupted, even for defibrillation attempts • Complete recoil of the chest in between compressions • Chest compression devices are recommended when • After the application of a defibrillator, defibrillation should not be delayed any further it is not practical to perform good manual compressions or the safety of the rescuer is compromised • Chest compressions should be continued • A pre-shock pause of 5–10 seconds already reduces the while the defibrillator is charging probability of a successful shock • <10 sec interruption before and after shock delivery F O C U S - O N - P A T I E N T S

ABSTRACT ABSTRACT STUDY The ERC guidelines recommend the shortest possible compres- manual defibrillation process should be possible with a compres- sion interruptions during cardiopulmonary resuscitation. Before sion break of less than 5 seconds (Monsieurs et al. 2015). and after the shock delivery, chest compressions should be When using the corpuls3 in combination with the corpuls interrupted for a maximum of 10 seconds. A peri-shock pause cpr in an in-house study, these recommendations could be (the compression break before and after defibrillation) of a noticeably undercut. With the synchronization of the corpuls3 maximum of 10 seconds has been scientifically proven to be and the corpuls cpr, this endeavour could be further increased. associated with a higher survival rate (Cheskes et al. 2014; With synchronized device operation, the hands-off time was Sell et al. 2010). According to the ERC guidelines, the entire reduced by 16.08%. c e s n i e m i t f f o - s d n a H Illustration 1: Representation of the hands-off time of our study comparing synchronized and disconnected device operation of the corpuls3 and corpuls cpr. (Significance P < 0.001: ***; P < 0.05: *) AED Mode (disconnected) AED Mode (synchronized) Manual (disconnected) Manual (synchronized) The reduction in the compression pause is particularly evident the peri-shock pause in disconnected mode of 3.24 ± 0.71 s. during the perishock pause. On average, the perishock pause This saving can be a valuable gain in time with the desired in synchronized mode of 2.00 ± 0.32 s is 38.23% shorter than break being a maximum of 5 seconds. c e s n i e s u a p k c o h s - i r e P Illustration 2: When comparing the peri-shock pauses, the significant minimization of the pause duration with synchronization compared to disconnected device operation of corpuls3 and corpuls cpr becomes particularly clear. (Significance P < 0.001: ***) AED Mode (disconnected) AED Mode (synchronized) Manual (disconnected) Manual (synchronised) References Cheskes, Sheldon; Schmicker, Robert H.; Verbeek, P. Richard; Salcido, David D.; Brown, Siobhan P.; Brooks, Steven et al. (2014): The impact of peri-shock pause on survival from out-of-hospital shockable cardiac arrest during the Resuscitation Outcomes Consortium PRIMED trial. In: Resuscitation 85, S. 336–342. DOI: 10.1016/j.resuscitation.2013.10.014. Kleinman, Monica E.; Brennan, Erin E.; Goldberger, Zachary D.; Swor, Robert A.; Terry, Mark; Bobrow, Bentley J. et al. (2015): Part 5. Adult Basic Life Support and Cardiopulmonary Resuscitation Quality. Circulation. 2015;132[suppl 2]:S414–S435. In: Circulation 132 (18 suppl 2), S. S414-S435. DOI: 10.1161/CIR.0000000000000259. Monsieurs, Koenraad G.; Nolan, Jerry P.; Bossaert, Leo L.; Greif, Robert; Maconochie, Ian K.; Nikolaou, Nikolaos I. et al. (2015): European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation 95 (2015) 1–80. In: Resuscitation 95, S. 1–80. DOI: 10.1016/j.resuscitation.2015.07.038. Nolan, Jerry P.; Soar, Jasmeet; Zideman, David A.; Biarent, Dominique; Bossaert, Leo L.; Deakin, Charles D. et al. (2010): European Resuscitation Council Guidelines for Resuscitation 2010. Section 1. Executive Summary. In: Resuscitation 81 (10), S. 1219–1276. DOI: 10.1016/j.resuscitation.2010.08.021. Perkins, Gavin D.; Olasveengen, Theresa M.; Maconochie, Ian; Soar, Jasmeet; Wyllie, Jonathan; Lockey, Robert Greif Andrew et al. (2017): ERC 2017 Guidelines Update. In: Resuscitation. DOI: 10.1016/j. resuscitation.2017.12.007. Sell, Rebecca E.; Sarno, Renee; Lawrence, Brenna; Castillo, Edward M.; Fisher, Roger; Brainard, Criss et al. (2010): Minimizing pre- and post-defibrillation pauses increases the likelihood of return of sponta- neous circulation (ROSC). In: Resuscitation 81 (7), S. 822–825. DOI: 10.1016/j.resuscitation.2010.03.013.

F O C U S - O N - P A T I E N T S SYNCHRONIZATION THERAPY Training not only means using existing knowledge, but also learning new techniques – that includes synchronized therapy with corpuls3 and corpuls cpr. Thanks to the Bluetooth connection from corpuls simulation, this feature can now be trained realistically at any time. All usage scenarios and benefits can be optimally taught for use in the field: simply connect corpuls simulation with the corpuls cpr (from software version 1.2) and take your training to a whole new level. * Using the combination of corpuls simulation and corpuls cpr only on training manikins THE FACTS THE ECONOMICAL SOLUTION • All the functions of the original device Training as with a high-end simulation manikin – • Realistic parameters and curves • Status changes through events • Scenario editor • Simulation consumables • Original accessories • The latest device software for the respective medical products • Multiple languages available • Safe training • corpuls simulation community but for a fraction of the price. Display of: • Different ECG rhythms • Perfusion dependent SpO2 curve • NIBP parameters or IBP with curve • etCO2 parameters and waveforms • CPR Feedbac k display corpuls simulation in action – • Bluetooth connection to corpuls cpr Find the video here.

F O C U S - O N - P A T I E N T S For over 35 years, corpuls® has developed and produced innovative high-end equipment for emergency and intensive care medicine. Today, in our headquar- ters in Kaufering, over 300 hearts each beat around 60,000 times every work day while aspiring to meet the high standards of rescue workers from over 70 countries around the world. corpuls defibrillators, patient monitoring systems and chest compression devices have set the standard since day one in the realisation of the most advanced insights in medical science, as well as in terms of innovation and ergonomics. Thus guaranteeing reliable and trusted aid in the fight for human lives. Manufacturer: corpuls | GS Elektromedizinische Geräte G. Stemple GmbH Hauswiesenstraße 26 | 86916 Kaufering Telephone +49 8191 65 722-0 E-Mail info@corpuls.com Web www.corpuls.world Products may not be available in all markets as product availability depends on the regulatory and/or medical processes in individual markets. For availability please contact info@corpuls.com. Printing errors as well as construction and design modification subject to change. All mentioned product names are registered trademarks of the respective owners. Art.-Nr. 76193.34020 Vers. 1.0 (10/20) ECGmax / CEB® are products of VectraCor | 785 Totowa Road, Suite 100 | Totowa NJ 07512 | USA ZOLL Medical Corporation 269 Mill Road | Chelmsford MA 01824-4105 | USA D L R O W . S L U P R O C . W W W