Correlating Intubation Times and Prehospital Cardiac Arrest Survival Rates

Street Science


 
 

Keith Wesley | | Wednesday, June 27, 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 ...

Featured Careers & Jobs in EMS





 

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Innovation & Progress

Follow in the footsteps of these inspirational leaders of EMS.
More >

Multimedia Thumb

Image Trend: ALS Ice Bucket Challenge

ImageTrend just challenged NEMSIS TAC and a couple others.
Watch It >


Multimedia Thumb

Where in the World of EMS is A.J.?

A.J. Heightman participated in the ALS Ice Bucket Challenge in a big way!
Watch It >


Multimedia Thumb

Details on Discipline Released in D.C. Investigation

Interim fire chief claims punishment was not severe enough.
Watch It >


Multimedia Thumb

Kentucky Firefighters Recovering from Injuries

One of the four remains in critical condition.
Watch It >


Multimedia Thumb

Numerous Rescues during Arizona Flooding

Severe flooding across the region prompted several rescues.
More >


Multimedia Thumb

Colorado Hiker Rescue

Injured hiker spent three hours in a crevice.
More >


Multimedia Thumb

Airlift at Swiss Train Derailment

Helicopters used to help reach the injured.
More >


Multimedia Thumb

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

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


Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >


Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >


More Product Videos >