Correlating Intubation Times and Prehospital Cardiac Arrest Survival Rates - @ JEMS.com


Correlating Intubation Times and Prehospital Cardiac Arrest Survival Rates

Street Science


 
 

Keith Wesley | | Tuesday, June 26, 2007


Review of: Shy D, Rea T, Becker L, et al: "Time to intubation and survival in prehospital cardiac arrest." Prehospital Emergency Care. 8(4):394-399, 2004.

The Science

This study from King County in Washington examined cardiac arrest records for a 12-year period from 1991 to 2003. The authors recorded the time from patient collapse until intubation and survival rate. They found that those patients that were intubated within 12 minutes had a survival rate of 46%, while those intubated after 13 minutes had a survival rate of 23%. The authors conclude that earlier intubation is associated with higher survival rate.

The Street

Just because one action is "associated" with another does not prove cause and effect. If you examine this study more closely, you see that all patients received BLS by EMT-Basics within four to six minutes. The major cause for delay in intubation was the delay in arrival of the paramedics. Also, patients intubated after 12 minutes were more likely to be in asystole, which is going to have a dismal survival rate despite intubation. The authors contend they took these factors into consideration, but I don t see it in the paper.

Additionally, Washington state EMT-Basics do not have advanced-airway training and therefore must rely on BVM airway management alone. This paper may represent more of a need for better BLS airway management than faster paramedics with ET tubes.

While I respect the passion for which these authors have approached the analysis of cardiac arrest, in the past, recent data suggest that intubation in and of itself is not associated with increased survival. We know that chest-compression-only CPR with an open and patent airway works, and airway management can interrupt chest compressions and increase intrathoracic pressures, both of which are associated with lower rates of survival.




Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Cardiac and Circulation, Airway and Respiratory, Research

What's Your Take? Comment Now ...

Buyer's Guide Featured Companies

Featured Careers & Jobs in EMS

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Improving Survival from Cardiac Arrest Using ACD-CPR + ITD

Using active compression-decompression CPR with an ITD has been shown to improve 1-year survival from cardiac arrest by 33%.
More >

Multimedia Thumb

Philadelphia Fire Department Apologizes for Medic’s Jab at Police

Union head calls photos a slap in the face of officers.
Watch It >


Multimedia Thumb

D.C. Fire and EMS Crews Blame New Technology for Patient’s Death

Delayed response blamed on recurring dispatch problems.
Watch It >


Multimedia Thumb

Suspect Steals, Crashes Maryland Ambulance

One killed, others injured in Prince George’s County crash.
Watch It >


Multimedia Thumb

Truck Strikes Pedestrians in Scotland

Six killed in downtown Glasgow.
More >


Multimedia Thumb

Tennessee Trench Rescue

Worker pulled from Roane County worksite.
More >


Multimedia Thumb

Time’s Ebola Firefighters

Doctors, nurses and others saluted for fighting virus.
More >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


Multimedia Thumb

The AmbuBus®, Bus Stretcher Conversion Kit - EMS Today 2013

AmbuBus®, Bus Stretcher all-hazards preparedness & response tool
Watch It >


Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >


More Product Videos >