Does prehospital intubation make a difference to survival rates in out-of-hospital cardiac arrest?

Egly et al (2011) conducted a retrospective review of a cardiac arrest database maintained by a large suburban emergency department in Michigan to which paramedics, from a combination of municipal and private provider agencies, transport cardiac arrest patients according to standardized regional protocols.

The study examined all cases of out-of-hospital cardiac arrest (OHCA) in patients aged >18 years that occurred between January 1995 and December 2006, with investigators manually reviewing notes to exclude cases of traumatic cardiac arrest and patients with prompt return of spontaneous circulation (ROSC) where endotracheal intubation (ETI) would not be indicated.

During the study period, ETI was considered the preferred method of airway management in cardiac arrest, with the Combitube used as a rescue device in cases where ETI failed.

Retrospective database analysis by Egly et al identified a total of 1515 nontraumatic adult cardiac arrest cases, with 33 survivors with prompt ROSC excluded.