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

Innovation & Advancement

This is the seventh year of the EMS 10 Innovators in EMS program, jointly sponsored by Physio-Control and JEMS.
More >

Multimedia Thumb

Salt Lake City Firefighters Injured in Firehouse Fire

Nine sent to a hospital with smoke inhalation.
Watch It >


Multimedia Thumb

Pennsylvania Paramedic Killed in the Line of Duty

West End Ambulance medic killed at accident scene.
Watch It >


Multimedia Thumb

Wesleyan Students Hospitalized for Overdose

11 students transported to local hospitals.
Watch It >


Multimedia Thumb

Rigs Going in Service from EMS Today 2015

Snap shots of some of the vehicles at EMS Today that will be on the streets soon
More >


Multimedia Thumb

Florida Hospital Fire

Fire halts construction project at Tampa cancer center.
More >


Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

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


Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >


Multimedia Thumb

Field Bridge Xpress ePCR on iPad, Android, Kindle Fire

Sneak peek of customizable run forms & more.
Watch It >


More Product Videos >