Association Between Prehospital ETI Attempts & Survival to Discharge?

In a retrospective study of data from an EMS system in Mecklenburg, N.C., investigators sought to determine whether prehospital endotracheal intubation attempts were associated with return of spontaneous circulation and survival to discharge in out-of-hospital cardiac arrest patients.¹ A total of 1,142 cardiac arrest patients between July 2006 and December 2008 were included in the study.

Prehospital ROSC occurred in 299 patients (26.2%). “When controlling for initial arrest rhythm and other confounding variables, individuals with no ETI attempted were 2.33 times more likely to have ROSC compared to those with one successful ETI attempt. Of the 299 individuals with prehospital ROSC, 118 (39.5%) were subsequently discharged alive from the hospital. Individuals having no ETI were 5.46 times more likely to be discharged from the hospital alive compared to individuals with one successful ETI attempt.”

The study suggests a “negative association” between prehospital ETI attempts and survival from out-of-hospital cardiac arrest. “In this study, the individuals most likely to have prehospital ROSC and survival to hospital discharge were those who did not have a reported ETI attempt. Further comparative research should assess the potential causes of the demonstrated associations,” researchers state in the study.

Reference

1. Studnek JR, Thestrup L, Vandeventer S, et al. The association between prehospital endotracheal intubation attempts and survival to hospital discharge among out-of-hospital cardiac arrest patients. Acad Emerg Med. 2010;17(9):987—988. doi:10.1111/j.1553-2712.2010.00827.x