Enhancing Prehospital Resuscitation: The Role of Paramedics in Delivering High-Quality CPR Using the LUCAS Device

Abstract

Out-of-hospital cardiac arrest (OHCA) is a major global health challenge, and survival outcomes remain closely linked to the quality and consistency of cardiopulmonary resuscitation (CPR). Manual CPR, although foundational, is affected by rescuer fatigue, interruptions, and variability in compression depth and rate, particularly during prolonged resuscitation and patient transport. The LUCAS mechanical chest compression device has emerged as a critical innovation in prehospital care by delivering automated, guideline-compliant compressions with minimal interruption. Paramedics play a pivotal role in deploying, operating, and integrating the LUCAS device within advanced life support protocols. This review examines the expanding responsibilities of paramedics in LUCAS-assisted resuscitation, synthesizing recent evidence on clinical effectiveness, operational advantages, and system-level impacts across emergency medical services (EMS). Studies from 2016 to 2025 indicate that LUCAS use improves compression consistency, enhances safety during transport, and reduces physical strain on providers. However, practical limitations—such as device application time, scene logistics, and training disparities—continue to influence patient outcomes. Understanding the interaction between paramedic proficiency, device performance, and EMS workflow is essential for optimizing prehospital resuscitation. The review concludes with strategic recommendations to enhance paramedic training, standardize protocols, and strengthen LUCAS integration into EMS systems.