Abstract
Objective: To assess interruptions in chest compressions associated with advanced airway placement during cardiopulmonary resuscitation (CPR) of out-of-hospital cardiac arrest (OHCA) victims. Methods: The method used was observational analysis of prospectively collected clinical and defibrillator data from 339 adult OHCA victims, excluding victims with <5 minutes of CPR. Interruptions in CPR, summarized by chest compression fraction (CCF), longest pause, and the number of pauses greater than 10 seconds, were compared between patients receiving bag valve mask (BVM), supraglottic airway (SGA), endotracheal intubation (ETI) via direct laryngoscopy (DL), and ETI via video laryngoscopy (VL). Secondary outcomes included first pass success and the effect of multiple airway attempts on CPR interruptions. Results: During the study period, paramedics managed 23 cases with BVM, 43 cases with SGA, 148 with DL, and 125 with VL. There were no statistically significant differences between the airway groups with regard to longest compression pause (BVM 18 sec [IQR 11–33], SGA 29 sec [IQR 15–65], DL 26 sec [IQR 12–59], VL 22 sec [IQR 14–41]), median number of pauses greater than 10 seconds (BVM 2 [IQR 1–3], SGA 2 [IQR 1–3], DL 2 [IQR 1–4], VL 2 [IQR 1–3]), or CCF (0.92 for all groups). However, each additional attempt following failed initial DL was associated with an increase in the risk of additional chest compression pauses (relative risk 1.29, 95% confidence interval 1.02–1.64). Such an association was not observed with additional attempts using VL or SGA. First pass success was highest with SGA (77%), followed by between DL (68%) and VL (67%); these differences were not statistically significant. Conclusions: While summary measures of chest compression delivery did not differ significantly between airway classes in this observational study, repeated attempts following failed initial DL during cardiopulmonary resuscitation were associated with an increase in the number of pauses in chest compression delivery observed.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 628-635 |
| Number of pages | 8 |
| Journal | Prehospital Emergency Care |
| Volume | 21 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 3 2017 |
| Externally published | Yes |
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Keywords
- advanced airway
- cardiac arrest
- chest compression fraction
- CPR quality
- endotracheal intubation
- out of hospital cardiac arrest
- resuscitation
- supraglottic airway
- video laryngoscopy
ASJC Scopus subject areas
- Emergency Medicine
- Emergency
Cite this
Advanced Airway Type and Its Association with Chest Compression Interruptions During Out-of-Hospital Cardiac Arrest Resuscitation Attempts. / Jarman, Angela F.; Hopkins, Christy L.; Hansen, J. Nicholas; Brown, Jonathan R.; Burk, Christopher; Youngquist, Scott T.
In: Prehospital Emergency Care, Vol. 21, No. 5, 03.09.2017, p. 628-635.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Advanced Airway Type and Its Association with Chest Compression Interruptions During Out-of-Hospital Cardiac Arrest Resuscitation Attempts
AU - Jarman, Angela F.
AU - Hopkins, Christy L.
AU - Hansen, J. Nicholas
AU - Brown, Jonathan R.
AU - Burk, Christopher
AU - Youngquist, Scott T.
PY - 2017/9/3
Y1 - 2017/9/3
N2 - Objective: To assess interruptions in chest compressions associated with advanced airway placement during cardiopulmonary resuscitation (CPR) of out-of-hospital cardiac arrest (OHCA) victims. Methods: The method used was observational analysis of prospectively collected clinical and defibrillator data from 339 adult OHCA victims, excluding victims with <5 minutes of CPR. Interruptions in CPR, summarized by chest compression fraction (CCF), longest pause, and the number of pauses greater than 10 seconds, were compared between patients receiving bag valve mask (BVM), supraglottic airway (SGA), endotracheal intubation (ETI) via direct laryngoscopy (DL), and ETI via video laryngoscopy (VL). Secondary outcomes included first pass success and the effect of multiple airway attempts on CPR interruptions. Results: During the study period, paramedics managed 23 cases with BVM, 43 cases with SGA, 148 with DL, and 125 with VL. There were no statistically significant differences between the airway groups with regard to longest compression pause (BVM 18 sec [IQR 11–33], SGA 29 sec [IQR 15–65], DL 26 sec [IQR 12–59], VL 22 sec [IQR 14–41]), median number of pauses greater than 10 seconds (BVM 2 [IQR 1–3], SGA 2 [IQR 1–3], DL 2 [IQR 1–4], VL 2 [IQR 1–3]), or CCF (0.92 for all groups). However, each additional attempt following failed initial DL was associated with an increase in the risk of additional chest compression pauses (relative risk 1.29, 95% confidence interval 1.02–1.64). Such an association was not observed with additional attempts using VL or SGA. First pass success was highest with SGA (77%), followed by between DL (68%) and VL (67%); these differences were not statistically significant. Conclusions: While summary measures of chest compression delivery did not differ significantly between airway classes in this observational study, repeated attempts following failed initial DL during cardiopulmonary resuscitation were associated with an increase in the number of pauses in chest compression delivery observed.
AB - Objective: To assess interruptions in chest compressions associated with advanced airway placement during cardiopulmonary resuscitation (CPR) of out-of-hospital cardiac arrest (OHCA) victims. Methods: The method used was observational analysis of prospectively collected clinical and defibrillator data from 339 adult OHCA victims, excluding victims with <5 minutes of CPR. Interruptions in CPR, summarized by chest compression fraction (CCF), longest pause, and the number of pauses greater than 10 seconds, were compared between patients receiving bag valve mask (BVM), supraglottic airway (SGA), endotracheal intubation (ETI) via direct laryngoscopy (DL), and ETI via video laryngoscopy (VL). Secondary outcomes included first pass success and the effect of multiple airway attempts on CPR interruptions. Results: During the study period, paramedics managed 23 cases with BVM, 43 cases with SGA, 148 with DL, and 125 with VL. There were no statistically significant differences between the airway groups with regard to longest compression pause (BVM 18 sec [IQR 11–33], SGA 29 sec [IQR 15–65], DL 26 sec [IQR 12–59], VL 22 sec [IQR 14–41]), median number of pauses greater than 10 seconds (BVM 2 [IQR 1–3], SGA 2 [IQR 1–3], DL 2 [IQR 1–4], VL 2 [IQR 1–3]), or CCF (0.92 for all groups). However, each additional attempt following failed initial DL was associated with an increase in the risk of additional chest compression pauses (relative risk 1.29, 95% confidence interval 1.02–1.64). Such an association was not observed with additional attempts using VL or SGA. First pass success was highest with SGA (77%), followed by between DL (68%) and VL (67%); these differences were not statistically significant. Conclusions: While summary measures of chest compression delivery did not differ significantly between airway classes in this observational study, repeated attempts following failed initial DL during cardiopulmonary resuscitation were associated with an increase in the number of pauses in chest compression delivery observed.
KW - advanced airway
KW - cardiac arrest
KW - chest compression fraction
KW - CPR quality
KW - endotracheal intubation
KW - out of hospital cardiac arrest
KW - resuscitation
KW - supraglottic airway
KW - video laryngoscopy
UR - http://www.scopus.com/inward/record.url?scp=85018355958&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85018355958&partnerID=8YFLogxK
U2 - 10.1080/10903127.2017.1308611
DO - 10.1080/10903127.2017.1308611
M3 - Article
C2 - 28459305
AN - SCOPUS:85018355958
VL - 21
SP - 628
EP - 635
JO - Prehospital Emergency Care
JF - Prehospital Emergency Care
SN - 1090-3127
IS - 5
ER -