Field intubation of patients with cardiac arrest: a dying art or just a question of timing?

Turgulov, Anuar; Rac, Valeria E.; Kierzek, G.; Morrison, Laurie J.

doi:10.1136/emj.2010.097808

Cited by 4 publications

(4 citation statements)

References 3 publications

(1 reference statement)

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“…However, because of its difficulty and complexity, it should be performed by an experienced EMT in cooperation with organized manpower. 3,[7][8][9] ETI showed superiority to SGA in prehospital ROSC regardless of tier type in this study. In Korea, prehospital providers are classified into level-1 EMT (EMTintermediate in the USA) and level-2 EMT (EMT-basic in the USA).…”

Section: Discussionmentioning

confidence: 48%

“…3,7 Prehospital ETI may worsen patient outcome when associated with delays in basic life support (BLS) procedures, interruptions in chest compressions, or unrecognized esophageal intubation. 8,9 A recent multicenter trial by Wang et al 10 showed that initial laryngeal tube insertion was associated with a greater survival rate in OHCA patients compared to initial ETI. However, the AIR-WAYS-2 randomized clinical trial, which compared ETI and SGA, reported that SGA did not show favorable functional outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, international recommendations suggest that ETI should be performed by operators with adequate experience and skills [ 3 , 7 ]. Prehospital ETI may worsen patient outcome when associated with delays in basic life support (BLS) procedures, interruptions in chest compressions, or unrecognized esophageal intubation [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Interactive effect of multi-tier response and advanced airway management on clinical outcomes after out-of-hospital cardiac arrest: a nationwide population-based observational study

Lim¹,

Song²,

Shin³

et al. 2022

Clin Exp Emerg Med

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Objective We hypothesized that a multi-tier response (MTR) will provide high-quality cardiopulmonary resuscitation including airway management. However, the type of tier response system and airway management will have different interactive effects resulting in varying outcomes following out-of-hospital cardiac arrest (OHCA). This study aimed to determine whether the advanced airway management method has an effect on OHCA outcomes and to compare the size of the effect across MTR types.Methods This is a retrospective population-based observational study using the Korea OHCA Registry. Airway management methods were categorized into endotracheal intubation (ETI) and supraglottic airway (SGA) groups. The tier system was categorized into single-tier response (STR) or two types of MTR: ambulance-ambulance MTR or fire engine-ambulance MTR.Results In total, 45,264 patients were analyzed among the 89,087 emergency medical service assessed OHCAs. The SGA group was significantly associated with a lower prehospital return of spontaneous circulation (ROSC) rate compared to the ETI group (adjusted odds ratio [aOR], 0.79; 95% confidence interval [CI], 0.72–0.88). Both MTR with an ambulance or fire engine were significantly associated with higher prehospital ROSC rates compared to STR (STR vs. MTR with an ambulance: aOR, 1.33; 95% CI, 1.21–1.47; STR vs. MTR with a fire engine: aOR, 1.43; 95% CI, 1.20–1.71). Prehospital SGA was significantly associated with poor neurological outcomes in MTR with fire engine (aOR, 0.71; 95% CI, 0.53–0.96).Conclusion In this nationwide observational study, we observed that MTR was associated with higher prehospital ROSC than STR. Moreover, SGA is associated with a lower prehospital ROSC rate regardless of tier response type compared to ETI.

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Section: Discussionmentioning

confidence: 48%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Interactive effect of multi-tier response and advanced airway management on clinical outcomes after out-of-hospital cardiac arrest: a nationwide population-based observational study

Lim¹,

Song²,

Shin³

et al. 2022

Clin Exp Emerg Med

View full text Add to dashboard Cite

show abstract

“…The emergence of alternative supraglottic airway (SGA) devices has led to calls for the withdrawal of paramedic ETI in favour of other techniques that may offer acceptable alternatives without the risks and complications associated with ETI . Other research suggests that the aetiology of the cardiac arrest or the sequencing of the procedure with other resuscitation tasks may be important factors in predicting the therapeutic value of ETI over other airway management approaches.…”

Section: Introductionmentioning

confidence: 99%

Influence of prehospital airway management on neurological outcome in patients transferred to a heart attack centre following out‐of‐hospital cardiac arrest

Edwards

Williams

Cottee

2018

Emerg Medicine Australasia

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Consensus statement: a framework for safe and effective intubation by paramedics

Gowens¹,

Aitken-Fell²,

Broughton³

et al. 2018

British Paramedic Journal

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Field intubation of patients with cardiac arrest: a dying art or just a question of timing?

Cited by 4 publications

References 3 publications

Interactive effect of multi-tier response and advanced airway management on clinical outcomes after out-of-hospital cardiac arrest: a nationwide population-based observational study

Interactive effect of multi-tier response and advanced airway management on clinical outcomes after out-of-hospital cardiac arrest: a nationwide population-based observational study

Influence of prehospital airway management on neurological outcome in patients transferred to a heart attack centre following out‐of‐hospital cardiac arrest

Consensus statement: a framework for safe and effective intubation by paramedics

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