OBJECTIVE: To examine the correlation between time to paramedic intubation and survival after prehospital cardiac arrest. METHODS: This was a retrospective cohort study of 693 patients who had paramedic endotracheal intubation for prehospital cardiac arrest in King County, Washington (excluding Seattle), between January 1991 and May 2003. Based on the time from patient collapse until intubation, cases were divided into quartiles. Survival in the slower three quartiles (defined as "slow intubation") was compared with survival in the fastest quartile (defined as "quick intubation"). RESULTS: In the quick intubation group (intubation time < or = 12 minutes), 46% of the patients survived; in the slow intubation group (intubation time > or = 13 minutes), 23% of the patients survived. Logistic regression was used to adjust for possible confounders that affect survival: age, gender, location, bystander cardiopulmonary resuscitation, cardiac rhythm, emergency medical technician response time, and paramedic response time. The fully adjusted odds ratio of survival for the slow intubation group compared with the quick intubation group was 0.42 (95% confidence interval 0.26, 0.69). CONCLUSIONS: This study is the first of its kind to compare survival with the time interval until an aspect of advanced life support is performed. These findings suggest that faster intubation times may increase odds of survival in prehospital cardiac arrest. Future prospective studies are merited to further understand this association.
OBJECTIVE: To examine the correlation between time to paramedic intubation and survival after prehospital cardiac arrest. METHODS: This was a retrospective cohort study of 693 patients who had paramedic endotracheal intubation for prehospital cardiac arrest in King County, Washington (excluding Seattle), between January 1991 and May 2003. Based on the time from patient collapse until intubation, cases were divided into quartiles. Survival in the slower three quartiles (defined as "slow intubation") was compared with survival in the fastest quartile (defined as "quick intubation"). RESULTS: In the quick intubation group (intubation time < or = 12 minutes), 46% of the patients survived; in the slow intubation group (intubation time > or = 13 minutes), 23% of the patients survived. Logistic regression was used to adjust for possible confounders that affect survival: age, gender, location, bystander cardiopulmonary resuscitation, cardiac rhythm, emergency medical technician response time, and paramedic response time. The fully adjusted odds ratio of survival for the slow intubation group compared with the quick intubation group was 0.42 (95% confidence interval 0.26, 0.69). CONCLUSIONS: This study is the first of its kind to compare survival with the time interval until an aspect of advanced life support is performed. These findings suggest that faster intubation times may increase odds of survival in prehospital cardiac arrest. Future prospective studies are merited to further understand this association.
Authors: Chika Nishiyama; Siobhan P Brown; Susanne May; Taku Iwami; Rudolph W Koster; Stefanie G Beesems; Markku Kuisma; Ari Salo; Ian Jacobs; Judith Finn; Fritz Sterz; Alexander Nürnberger; Karen Smith; Laurie Morrison; Theresa M Olasveengen; Clifton W Callaway; Sang Do Shin; Jan-Thorsten Gräsner; Mohamud Daya; Matthew Huei-Ming Ma; Johan Herlitz; Anneli Strömsöe; Tom P Aufderheide; Siobhán Masterson; Henry Wang; Jim Christenson; Ian Stiell; Dan Davis; Ella Huszti; Graham Nichol Journal: Resuscitation Date: 2014-07-08 Impact factor: 5.262