The Origin of the ElevatedCPRTM Method.
In the early 2010’s, Korean clinicians faced the challenge of extracting cardiac arrest victims from the small elevators pervasive in Asian apartment complexes, and determined that a change in patient positioning might provide a solution.
The physicians were working with a patient stretcher that could be tilted to fit into the elevator without stopping CPR and recommended tilting the head of the patient down during extrication, based on a theory that blood draining from the lower trunk and legs from the force of gravity would increase blood flow to the heart and brain and produce better outcomes.
In 2014, Keith Lurie, M.D., founder of AdvancedCPR Solutions and a globally-respected expert and researcher in resuscitation, and his team analyzed the impact of head down positioning on patient physiology and hemodynamics. Dr. Lurie and his team used their proven cardiac arrest animal model, monitoring systems and an automated CPR device with a tilt table that could tilt the entire body up or down.
They first replicated the Korean recommendation for head down CPR and saw an immediate, profound and dangerous increase in intracranial pressure and a corresponding decrease in cerebral perfusion pressure – exactly the opposite of what was expected and needed.
The team decided to investigate what would happen if the patient were tilted the other direction – into a head up or elevated position. Surprisingly, the exact opposite of what was expected occurred – both the intracranial pressure fell and cerebral perfusion pressure increased by statistically significant levels.
Their research into head up positioning and device-assisted head up CPR continued forward and is the basis for the ElevatedCPR method. Lurie and his team have published a number of scientific papers about the ElevatedCPR method and its potential benefits as an additional recommendation to address sudden cardiac arrest.