The Outcomes of Endotracheal Intubation versus Non-Endotracheal Intubation during Cardiopulmonary Arrest in the Emergency Department

Abstract

Airway management techniques during cardiopulmonary arrest in the emergency department may impact short and long-term outcomes of these patients. Prior studies addressing airway management of patients in cardiopulmonary arrest in the emergency department are limited. We aimed to evaluate the one-month neurological outcomes post cardiac arrest as a primary endpoint. Our secondary endpoint was to look at return of spontaneous circulation rates and survival to discharge. We retrospectively reviewed cardiac arrest flow sheets of patients sustaining in-emergency department cardiopulmonary arrest between January 2017 and September 2017. We looked at the different types of airway management techniques and their effect on patient outcomes. Patients who received non-endotracheal intubation during cardiopulmonary arrest had higher rates of good neurological outcome (GCS > 9) at one month when compared with patients who received endotracheal intubation: 8 (32%) vs. 2 (5.3%), respectively. Our results revealed a significant association of non-endotracheal intubation (bag-valve mask or laryngeal mask airway) with return of spontaneous circulation rates (p 0.044), survival to discharge (p < 0.001), and good neurological outcome (GCS > 9) (p 0.008). Although non-endotracheal intubation during cardiopulmonary arrest is not common, we encourage the increased use of bag-valve mask and laryngeal mask airways during cardiopulmonary arrest as they are associated with better outcomes.