Executive-Summary

Heart Compression Resuscitation LLC

A New Standard for "Feel'n Real" CPR Training Manikins

EXECUTIVE SUMMARY

Heart Compression Resuscitation, LLC (HCR or the Company) is a developer of innovative, patented, dramatically more “true-to-life” CPR training manikins. HCR’s CPR manikins are specifically designed to provide both professionals and potential bystanders with substantially more realistic, more effective, and better recalled CPR training.

Several organizations, including the American Heart Association (AHA), have stated that CPR manikins need to be more realistic and, given the critical role of effective chest compressions, must do a better job of replicating the dynamics of the human chest during CPR. The new HCS 110 Compression device or device incorporated into a headless torso CPR manikin (known as “Chest Compression Charlie”) is unique in its ability to meet these requirements and, as the result of patented technology, is dramatically superior to any other CPR Training Tool now in the marketplace.

According to the AHA, there are more than 380,000 victims of out-of-hospital cardiac arrest each year in the United States. However, less than eight (8) percent of these victims survive. The AHA emphasizes that “effective bystander CPR could double or even triple a victim’s chance of survival” (many others believe that the survival rate could even be higher with improved CPR manikins and training techniques).

It is widely believed by the AHA, the American Medical Association (via their JAMA publication), and many others, that CPR training in its totality has been ineffective and that any training benefits are not retained longer than 6-12 months. As a result, bystanders hesitate to step forward to assist cardiac arrest victims (occurs less than a third of the time), because their training can’t be recalled, they lack the confidence to perform, and/or they are afraid they might injure the victim. In addition, many studies have indicated that health professionals also often perform CPR poorly for lack of proper training and recall.

Several organizations, including the AHA, have stated that CPR manikins need to be more realistic and, given the critical role of effective chest compressions, must do a better job of replicating the dynamics of the chest during CPR.

HCR’s NEW CPR TRAINING MANIKIN WILL HELP SAVE LIVES

The AHA has emphasized in its most recent guidelines that truly effective life-saving CPR depends primarily on performing chest compressions that are at least 2 inches deep, delivered at a suggested 100 pounds of thrust, and performed at the rate of 100 compressions per minute. Chest Compression Charlie is the only CPR manikin that supports all of these guidelines.

Chest Compression Charlie will provide a dramatically improved and uniquely realistic CPR training experience in the following ways:

Chest Compression Charlie provides a realistic simulation of the sound and feel of the tearing of cartilage and the breaking of ribs that are both characteristic of properly delivered CPR. The AHA and others (including Chest Compression Charlie’s beta testers), have stated that these effects are a common occurrence. Dr. Michael Sayre, a spokesman for the AHA, has stated that “broken ribs are to be expected when doing CPR”. The National Institutes of Health states that rib cracking etc. (which occurred in 94% of their test sample) is commonly under investigated and, therefore, not reported. Consequently, the actual physical dynamics and “real feel” of applying CPR to a victim have historically been ignored in CPR training. HCR’s patented simulation of cartilage tearing and rib cracking is not a feature of any other CPR training manikin in the marketplace today (see HRC’s enclosed whitepaper “Frequency of Injuries Associated with CPR”).

Studies at the University of Pennsylvania and elsewhere have shown that the human chest, once compressed, does not just pop back into place. In reality, the recoil of the chest is "damped" as opposed to being linear. Chest Compression Charlie is the only CPR training manikin that has been purposely designed to replicate such dynamics of the human chest during CPR.

Chest Compression Charlie provides audible feedback when chest compressions achieve the required depth of at least two inches. Only two other CPR training manikins provide this sort of feedback, but at a depth of less than the AHA required two inches.

Chest Compression Charlie provides a soundtrack of the Bee Gees "Staying Alive" (used by the AHA in its own training videos) to set the proper pace required to achieve 100 compressions per minute. This feature, together with Charlie’s enhanced life-like feel, will have direct and lasting impact on learning the correct psychomotor skills, and will significantly lengthen training recall. This sense stimulating feature is not found in any other CPR manikin (there is one other CPR manikin that does provide some guidance with compression rate through less effective means).

As a result of its unique and groundbreaking features, Chest Compression Charlie will enable CPR trainees (both bystanders and professionals) to learn CPR faster, to learn CPR more effectively, and, as a result of the more intense "feel and sound" experience, to remember it much longer. This more realistic training experience will give trainees the confidence that they will actually be able to save lives...and more lives will be saved.

MARKET SIZE

CPR training manikins are used globally by a large number of organizations, including AHA training centers, American Red Cross training centers, fire departments, police departments, private training companies, military bases, ambulance companies, hospitals, medical schools, schools and colleges, and many private corporations. Recent research has indicated that both junior high schools and high schools are adding CPR training to their curriculum and that such training is mandated for graduation from a growing number of schools.

It is also expected that the AHA’s new emphasis on performing quality chest compressions (versus having to breath into the victim) will result in less resistance by bystanders to step forward to apply CPR, and greater public interest in receiving CPR training.

Based upon HCR’s market research, including third party research and primary research through its beta test audience (plus over 100 phone calls with users throughout the U.S.), HCR estimates that there are approximately 4.5 million CPR manikins in use around the world. Conversations with buyers of CPR manikins indicate that manikins are replaced roughly every three years. This calculates to a total annual worldwide market for CPR manikins of approximately 1.5 million manikins. According to Global Industry Analysts, Inc. (GIA) in their 2009 report, the U.S. represents approximately 38% of this market and the market in the U.S. and Europe is growing approximately 2.5% per year. In a more recent report, GIA forecasted that growth in other areas of the world would be greater: “robust growth prospects are expected from the developing markets of Eastern Europe, Russia, the Far East, and Asia-pacific where the emergency sectors and hospital systems are still evolving”.

MARKET PENETRATION STRATEGY

Acquisitions are a common source of growth in the industry. Management believes that once potential licensees &/or other manufacturers and investment groups become aware of this product, so desired by the AHA per their last 3 "guidelines", where they request that the industry develop "more realistic" cpr training manikins with a focus on better chest compression trainings. That one or more of its industry competitors or other leading manufacturers will be open to meeting and reviewing a licensing agreement or a direct buy out. HCR LLC will be pursuing such parties starting in September 2018...

FUNDING REQUIREMENTS Completed for Phase 5… thou additional funding excepted in Phase 6 until negotiations are started for licensing or a sale. Phase 6 Funding will be for Marketing Expenses to accomplish a Licensing Agreement or Sale of HCR LLC.

MANAGEMENT TEAM

Dan May, Founder, President and CEO

Mr. May earned a bachelors’ degree in Physical Education from the State University of New York.

In his younger years, Dan was a life guard and then a water safety instructor for the American Red Cross. At this time, he was also the director of a local swim program and taught CPR to lifeguards in training. This experience provided Dan with an early introduction to the need for more realistic manikins for CPR training.

For over thirty years, including ten years more recently with Stantec Consulting Inc, Dan was a construction inspector and oversaw a large number of significant projects in the Tucson area, including expansion at the Tucson International Airport, several projects in the development and expansion of Sahuarita, the Continental Reserve infrastructure loop and subdivisions, and many other projects. Dan also developed the project inspection scopes, which guided Stantec’s engineers in certifying the construction of their project plans.

Since 2009, Dan has dedicated his time to launching and guiding the progress of HCR.

Larry Bramlett, Consultant and Acting Vice President, Engineering

Mr. Bramlett holds an Associate degree in liberal arts and pursued a B.S. degree in mechanical engineering.

Working in conjunction with Dan May, Mr. Bramlett has been responsible for the engineering design and development of the HCR device, which is the core of Chest Compression Charlie. Larry and Dan are both owners of the patents filed for the HCR device. Mr. Bramlett also holds patents in other fields in addition to applications that are currently undergoing review by the US Patent Office. Larry has over thirty-nine years of experience as a design engineer, engineering manager, and project manager, and has managed up to forty engineers and designers in contiguous technical efforts.

In addition to owning an engineering and design consulting firm, he spent sixteen years as senior product design engineer for the Citibank Development Division and then spent six years in a similar position with Competitive Engineering, Inc. Over this span of time, Larry was responsible for the successful completion of a wide range of projects, including the design of high-energy magnet power supply systems for fusion energy research, high technology electro-mechanical security devices for the banking industry, the electro-mechanical design of embedded computer engines, the layout of dense multi-layer circuit boards, and the pneumatics, mechanical mechanisms, hydraulics and interfaces for control electronics and precision vision equipment. Larry was also the program manager of a successful effort to develop a new automatic teller machine on behalf of Citicorp and NCR.

Robert Fick, Consultant, Acting Vice President and Chief Financial Officer

Mr. Fick is a graduate of the University of Arizona and holds a Masters of Business Administration from the University of Redlands in California.

Bob spent over twenty-five years as a senior vice president and chief financial officer of fast growing private and publicly traded companies, primarily in the computer, software, and telecommunications industries. Between corporate assignments, Bob also started and managed a software business, which he sold following five years of profitable operations.

Bob’s corporate involvement included the turnaround of a venture capital funded computer software company, which as its CFO he was instrumental in taking public, the turnaround of a publicly traded telecommunications manufacturer, the turnaround of a telecommunications distribution company, which as its CFO he helped grow from $35 million to $180 million in sales in three years, and the start-up of an e-retailer.

Following his corporate career, Bob provided business brokerage and management consulting services for small business and then, starting in 2002, served for ten years as a senior business analyst and director of the Tucson SBDC.

Tom Shambo, Marketing Consultant

Mr. Shambo is a graduate of the University of Bellevue, Bellevue, Nebraska where he earned his degree of Bachelor of Science in Business Management.

Tom founded and operated several successful businesses, including Founders Financial Services, Inc. and LaserLaw, Inc. where he developed new technology solutions to enhance product delivery and services for banking and legal firms in Nebraska and many other states.

In 1996, Tom was recruited by Ernst and Young’s Cap Gemini in Kansas, Missouri as its senior manager. While with Cap Gemini, he initiated new strategies for the sales and marketing and delivery of information technology services to Cap Gemini’s customers. In 2003, Tom founded Shambo & Associates, LLC, which provides strategic planning, disaster recovery planning, and compliance services for the federal government and organizations in southern Arizona. In 2005, Tom joined the Tucson Small Business Development Center (SBDC) where he provided consulting services for small business and later became its director. While with the SBDC, Tom was continually recognized for his ability to build strong working relationships with other key organizations in Pima County, including the Desert Angels, chambers of commerce, SCORE, and the University of Arizona business incubator.

Earlier in his life, Tom had substantial practice with the application of CPR as a policeman then Chief of Police, and previously as an EMT and CPR instructor. He also served as a volunteer captain for his community ambulance service.

BOARD OF ADVISORS

Sharon Hollingsworth

Sharon is the Training Director for the Pima Community College fire department training program. She has provided valuable advice regarding the “feel” of the HCR CPR manikin, as well as, the potential value the manikin will be to EMS testing and certification.

Emre Toker

Mr. Toker is a serial entrepreneur, a member of the Desert Angels, and formerly was the University of Arizona McQuire Center Mentor-in-Residence. He is currently the managing director of the Skandalaris Center for Entrepreneurial Studies at Washington University, St. Louis, Missouri. Mr. Toker has provided advice regarding market research, product costing, company valuation, and investor requirements.

NOTES ON THE DESIGN OF HCR’S CPR TRAINING MANIKIN

HCR’s CPR manikins were developed using patented technology, which draws from recent scientific studies and uniquely supports the latest American Heart Association (AHA) guidelines regarding effective CPR. Management believes that HCR’s manikin represents a dramatic improvement to what is currently available in the industry, because of its unique ability to replicate the dynamics of the human chest during CPR.

Replicating the dynamics of the human chest during CPR chest compression and recoil, the dynamics of the latter being counter-intuitively non-linear, is not easily accomplished and simply has not been adequately addressed by existing CPR manikins. Using patented technology, the HCR manikin was designed and developed to address these issues and more.

HCR LLC has developed 2 training versions of the HCS 110 Compression Device.

(See IP & White Paper Page link on home page)

One with a headless Torso, which the CPR Industry is moving towards as Chest Compression Only Method has become very accepted by the AHA, AMA & Red Cross.

The other is the Compression Device with "Chest Plate", reducing the manufacturing "Cost of Goods", increasing the Gross Margin, which is very high.

While designing its device and manikin, HCR sought feedback from a large number of training personnel and users of CPR manikins in a variety of organizations, including AHA training centers, Red Cross training centers, fire station captains and firefighters, and others. These professional trainers and life savers performed substantial beta testing on HCR’s manikin. They commonly reacted with statements like “It usually requires multiple compressions to crack through the ribs of a victim; the device does a good job simulating that”; “Compression force and rebound feel quite accurate”; “We would upgrade today if available”. A fire department medical director remarked: “Gentlemen, that’s just how it should feel. I think you guys have a winner here”.

HCR also consulted with Dr. Nadkarni (director of the Center for Simulation, Advanced Education and Innovation) and other personnel at the Children’s Hospital of Philadelphia (CHOP). During visits to CHOP, HCR received valuable feedback on the efficacy of the design and realism of HCR’s CPR training device. HCR has taken advantage of this feedback to constantly improve and refine the final manikin design.

CHOP personnel have also been working with UPENN in their research project to recreate the feel of the human chest during CPR. The HCR device has been designed (with consideration to both practical design and manufacturing cost) to closely replicate the “hysteresis” of the human chest as observed by UPENN and others.

ADDITIONAL BACKGROUND INFORMATION

The AHA issued its first CPR guidelines in 1966. For years, these guidelines emphasized “ABC” for airway, breathing, and chest compression in that order of importance. Over time, however, there became increasing evidence that chest compressions, when properly delivered, are the most important component of life saving CPR for victims of cardiac arrest. In fact, several studies, involving thousands of actual cardiac arrest victims, have indicated that performing chest compressions only (without stopping to clear the airway and breath into the victim) provides survival results at least as high and usually superior to conventional CPR. For example, the University of Arizona (UA) Sarver Heart Center has championed the “hands only” chest compression method for years, and a statewide Arizona study by UA claimed a 300% greater success rate versus conventional CPR. In addition, a study in Japan involving 1,376 patients found better neurological outcomes after one month in cases where chest compression only CPR was performed versus the use of conventional CPR.

In 2010, the AHA dramatically modified its CPR guidelines and changed the recommended priority sequence to “CAB” giving chest compressions the highest priority. These revised guidelines also emphasized that, in order to be effective, chest compressions need to be at least two inches in depth and applied at a rate of one hundred (100) compressions per minute. Research has shown that chest compressions of this depth and rate are required to properly stimulate blood circulation to the brain and vital organs—arterial blood pressure increases with increasing compression force.

In its journal (“Circulation”, 2008), the AHA addressed the need to reduce the barriers to bystander CPR by suggesting that the quality of CPR provided by every rescuer (trained bystanders and trained professionals alike) must improve, and that chest compressions have been too shallow and are frequently interrupted. Like the JAMA and many other sources, the AHA also observed that the poor performance by bystanders and professionals is the result of the failure to recall CPR training, lack of confidence in doing the right thing, and fear of failure.

In 2008, JAMA reported that, based upon its recent study, (1) CPR quality performed by lay rescuers and health care professionals tends to deteriorate significantly within a few months after training and (2) more than fifty (50%) percent of the chest compressions performed by professionals are too shallow. According to JAMA, “training programs for CPR have been implemented worldwide during the last four decades following guidelines from the AHA and the European Resuscitation Council…but neither the effects of such training programs on clinical CPR nor the effects of specific criteria or overall quality of CPR on patient survival have been clinically documented”. The article concluded that “based upon the outcomes, the extrapolation from manikin performance can be questioned---there is an urgent need to promote better CPR and improve the way CPR is taught”.

According to a 2008 article in IEEE Trans Biomed Engineering, “Commercially available training manikins for CPR do not accurately mimic the mechanical properties of human chests…” (given this lack of realism of currently available CPR manikins, it is very common for CPR trainers, as well as a recommendation by the AHA, to remind trainees to “remember to push hard”).

The University of Pennsylvania (Upenn) has been researching the rescuer’s feel of the human chest during CPR. Their recent abstract states “It is well known that the human chest exhibits a strong force-displacement hysteresis during CPR, a stark contrast to the non-hysteretic behavior of standard spring manikins. We hypothesize that individuals with experience performing CPR on humans would perceive a manikin with damping as more realistic and better for training” (“damping” refers to more accurately replicating the recovery dynamics of the human chest during CPR). HCR’s CPR manikin stands alone in its ability to replicate this dynamic of the human chest.