Having spent many years from the 1990s lecturing to medical students and nurses on the evidence-based management of cardiac arrests, the development of the LUCAS device to enhance cardiothoracic compression is surely a miracle in the making. (Hearts a-flutter over new miracle machines, ST, 21/5). With pressure variation in the chest cavity, both ventilation and perfusion can be augmented by this brilliant innovation, as the suction arm allows negative pressures in the upstroke cycle, enhancing artificial cardiac output. Mark Stackley certainly had dedicated care with his resuscitators persisting even after 19 failed cardioversions, a cramped elevator ride and a whole hour of arrest time. The longest CPR time in my career was six hours and required a definite level of fitness to maintain efficiency. While many trained in CPR are easily found in medical institutions to share the work, the roadside paramedic will certainly benefit from Health Minister Ryan Park’s excellent decision to distribute the LUCAS device to their ambulances, reducing the hazards of operating in a confined space and with limited manpower. Alan Sexton, North Parramatta. 28May2023.