Field intubation of cardiac arrest patients: a dying art?

Lyon, Richard; Ferris, John D.; Young, Danielle M.; McKeown, Dermot; Oglesby, Angela J.; Robertson, Colin E.

doi:10.1136/emj.2009.076737

Cited by 55 publications

(37 citation statements)

References 15 publications

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“…1,2 ETI during CPR has a high rate of first-attempt failure, can cause prolonged interruption of chest compressions, and may be associated with poor outcomes for cardiac arrest victims. [3][4][5] Various factors including anatomical variation in patients' airways, the airway device selected, the operator's skill level, and other unpredictable situational conditions can affect the success of ETI and the occurrence of complications. Among these factors, the most important factor contributing to the difficulty of ETI may be the inherent technical problem of using direct laryngoscopy (DL).…”

Section: Introductionmentioning

confidence: 99%

Video laryngoscopy improves the first-attempt success in endotracheal intubation during cardiopulmonary resuscitation among novice physicians

Park

Kim

et al. 2015

Resuscitation

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Section: Introductionmentioning

confidence: 99%

Video laryngoscopy improves the first-attempt success in endotracheal intubation during cardiopulmonary resuscitation among novice physicians

Park

Kim

et al. 2015

Resuscitation

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“…Furthermore, other interventions often occur concurrently with ETI like chest compressions, electrical therapy, intravenous access, or the administration of drugs and ETI may influence patient outcome by interacting with or affecting the execution of these simultaneous therapies resulting in unintended hyperventilation, which may be deleterious in certain conditions and may increase the mortality, as shown by Davis and coll [25]. These observations contradict the assumption that aggressive airway intervention is associated with improved resuscitation outcomes [26]. Finally, last but not least, in our study the rate of stent thrombosis was significantly higher in the ETI group.…”

Section: Discussionmentioning

confidence: 99%

Endotracheal intubation and outcome in high-risk patients with acute myocardial infarction undergoing primary angioplasty

Tomassini¹,

Gagnor²,

Montali³

et al. 2014

J Anesthesiol Clin Sci

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Background: Patients with acute myocardial infarction (AMI) who undergo endotracheal intubation (ETI) are at high risk for mortality, but the outcome of those patients submitted to primary angioplasty (PCI) has not yet clearly reported. Methods:We collected data about all consecutive patients with AMI within 12 hours who underwent primary PCI and analyzed clinical and procedural characteristics as well as in-hospital mortality of ETI compared to no-ETI patients. Results: From September 2001 to June 2010, 1251 patients underwent primary PCI and 99 (7.9%) of them underwent ETI. ETI patients were more likely to be hypertensive (76.8% vs 67.8%, p=0.003), diabetic 43.4% vs 17.9%, p<0.0001), resuscitated by cardiac arrest (68.7% vs 0.7%, p<0.0001), to present with cardiogenic shock (CS) (61.6% % vs 8.1%, p<0.0001), with a lower left ventricular ejection fraction (LVEF) (38.9±9.4% vs 48.9±9.2%, p<0.0001) and to be treated with intra-aortic balloon counterpulsation (IABP) (60.1% vs 15.4%, p<0.0001). The in-hospital mortality was higher in ETI patients (37.4% vs 4.3%, p<0.0001) and they were more likely to undergo stent thrombosis (3% vs 0.34%, p=0.006). After using the propensity score modelling. Considering the risk profile, ETI was associated to higher in hospital mortality in the patients at higher risk (39.8% vs 18.5%, p=0.003). Moreover, ETI was one of the most powerful predictors of in-hospital mortality at multivariate analysis (OR 37.04, 95% CI 6.0-228.45, p=0.0001). Conclusions: ETI was found to be an independent predictor of mortality in high-risk AMI patients undergoing primary angioplasty. The implications for current clinical care remained undefined.

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“…10 Intubation was compared with the use of extraglottic devices, and while some authors believe the latter to be more efficacious, 11 others claim they cannot be considered superior to the more invasive methods, but represent a valid alternative to TI. [12][13][14] Other researchers did not find any difference between the two methods in terms of the neurological outcomes of patients surviving the sudden cardiac arrest. 15 According to certain researchers, the different methods of basic and advanced airway management are not related to patient survival and post-anoxia consequences.…”

Section: Articlementioning

confidence: 95%

Nurses and advanced airway management: the experience of the Piacenza ambulance service

et al. 2015

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The study examined the intubation manoeuvres performed by Piacenza local health authority ambulance service nurses in patients with sudden cardiac arrest of nontraumatic origin. The study has a retrospective observational design and analyzes all the intubation manoeuvres performed by ambulance service nurses in patients with non-traumatic cardiac arrest between January 2010 and December 2013. The success of the procedure with subglottic tubes was 97.7% (P>0.60), while it was 100% (P>0.50) with supraglottic devices. The success rate of the procedures is encouraging and the statistical analysis showed that there are no significant differences between literature data and the experience of Piacenza ambulance system crews. An increase in the use of supraglottic devices was also observed. The results show that the Piacenza ambulance service nursing staff has a good level of skills and competence in advanced airway management. A future development of this ability could involve intubation also in situations other than cardiac arrest using specific medication.

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Field intubation of cardiac arrest patients: a dying art?

Cited by 55 publications

References 15 publications

Video laryngoscopy improves the first-attempt success in endotracheal intubation during cardiopulmonary resuscitation among novice physicians

Video laryngoscopy improves the first-attempt success in endotracheal intubation during cardiopulmonary resuscitation among novice physicians

Endotracheal intubation and outcome in high-risk patients with acute myocardial infarction undergoing primary angioplasty

Nurses and advanced airway management: the experience of the Piacenza ambulance service

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