Annals of Emergency Medicine
Volume 54, Issue 5 , Pages 645-652.e1 , November 2009

Interruptions in Cardiopulmonary Resuscitation From Paramedic Endotracheal Intubation

Presented at the Society for Academic Emergency Medicine annual meeting, May 2008, Washington, DC.

Received 16 December 2008 ,Revised 14 May 2009 ,Accepted 21 May 2009.

References 

  1. Nichol G, Thomas E, Callaway CW, et al. Regional variation in out-of-hospital cardiac arrest incidence and outcome. JAMA. 2008;300:1423–1431
  2. Jacobs LM, Berrizbeitia LD, Bennett B, et al. Endotracheal intubation in the prehospital phase of emergency medical care. JAMA. 1983;250:2175–2177
  3. Stewart RD, Paris PM, Winter PM, et al. Field endotracheal intubation by paramedical personnel (Success rates and complications). Chest. 1984;85:341–345
  4. DeLeo BC. Endotracheal intubation by rescue squad personnel. Heart Lung. 1977;6:851–854
  5. Guss DA, Posluszny M. Paramedic orotracheal intubation: a feasibility study. Am J Emerg Med. 1984;2:399–401
  6. Aufderheide TP, Lurie KG. Death by hyperventilation: a common and life-threatening problem during cardiopulmonary resuscitation. Crit Care Med. 2004;32(9 suppl):S345–S351
  7. Aufderheide TP, Sigurdsson G, Pirrallo RG, et al. Hyperventilation-induced hypotension during cardiopulmonary resuscitation. Circulation. 2004;109:1960–1965
  8. Davis DP, Dunford JV, Poste JC, et al. The impact of hypoxia and hyperventilation on outcome after paramedic rapid sequence intubation of severely head-injured patients. J Trauma. 2004;57:1–8discussion 8-10
  9. Hazinski MF, Nadkarni VM, Hickey RW, et al. Major changes in the 2005 AHA guidelines for CPR and ECC: reaching the tipping point for change. Circulation. 2005;112(24 suppl):IV206–IV211
  10. Wang HE, Kupas DF, Greenwood MJ, et al. An algorithmic approach to prehospital airway management. Prehosp Emerg Care. 2005;9:145–155
  11. Wang HE, Yealy DM. How many attempts are required to accomplish out-of-hospital endotracheal intubation?. Acad Emerg Med. 2006;13:372–377
  12. Abo BN, Hostler D, Wang HE. Does the type of out-of-hospital airway interfere with other cardiopulmonary resuscitation tasks?. Resuscitation. 2007;72:234–239
  13. Fales W, Farrell R. Impact of new resuscitation guidelines on out-of-hospital cardiac arrest survival [abstract]. Acad Emerg Med. 2007;14:S157–S158
  14. Davis DP, Garberson LA, Andrusiek DL, et al. A descriptive analysis of emergency medical service systems participating in the Resuscitation Outcomes Consortium (ROC) network. Prehosp Emerg Care. 2007;11:369–382
  15. Morrison LJ, Nichol G, Rea TD, et al. Rationale, development and implementation of the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest. Resuscitation. 2008;78:161–169
  16. Abella BS, Alvarado JP, Myklebust H, et al. Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA. 2005;293:305–310
  17. Wik L, Kramer-Johansen J, Myklebust H, et al. Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA. 2005;293:299–304
  18. Katz SH, Falk JL. Misplaced endotracheal tubes by paramedics in an urban emergency medical services system. Ann Emerg Med. 2001;37:32–37
  19. Wang HE, Kupas DF, Paris PM, et al. Preliminary experience with a prospective, multi-centered evaluation of out-of-hospital endotracheal intubation. Resuscitation. 2003;58:49–58
  20. Wang HE, Lave JR, Sirio CA, et al. Paramedic intubation errors: isolated events or symptoms of larger problems?. Health Aff (Millwood). 2006;25:501–509
  21. Dunford JV, Davis DP, Ochs M, et al. Incidence of transient hypoxia and pulse rate reactivity during paramedic rapid sequence intubation. Ann Emerg Med. 2003;42:721–728
  22. Christenson J, Andrusiek D, Everson-Stewart SP, et al. Abstract 5: CPR fraction prior to defibrillation determines survival in prehospital cardiac arrest in the Resuscitation Outcomes Consortium (ROC) epistry. Circulation. 2007;116:II-923–d-924
  23. Bobrow BJ, Clark LL, Ewy GA, et al. Minimally interrupted cardiac resuscitation by emergency medical services for out-of-hospital cardiac arrest. JAMA. 2008;299:1158–1165
  24. Berg RA, Sanders AB, Kern KB, et al. Adverse hemodynamic effects of interrupting chest compressions for rescue breathing during cardiopulmonary resuscitation for ventricular fibrillation cardiac arrest. Circulation. 2001;104:2465–2470
  25. Kern KB, Hilwig RW, Berg RA, et al. Efficacy of chest compression-only BLS CPR in the presence of an occluded airway. Resuscitation. 1998;39:179–188
  26. Wang HE, Seitz SR, Hostler D, et al. Defining the learning curve for paramedic student endotracheal intubation. Prehosp Emerg Care. 2005;9:156–162
  27. Wang HE, Kupas DF, Hostler D, et al. Procedural experience with out-of-hospital endotracheal intubation. Crit Care Med. 2005;33:1718–1721
  28. Johnston BD, Seitz SR, Wang HE. Limited opportunities for paramedic student endotracheal intubation training in the operating room. Acad Emerg Med. 2006;13:1051–1055
  29. Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO study group). an observational study. Lancet. 2007;369:920–926
  30. Deakin CD, O'Neill JF, Tabor T. Does compression-only cardiopulmonary resuscitation generate adequate passive ventilation during cardiac arrest?. Resuscitation. 2007;75:53–59

 Provide feedback on this article at the journal's Web site, www.annemergmed.com.

 Dr. Wang is now affiliated with the Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL.

 Supervising editor: Daniel W. Spaite, MD

 Author contributions: HEW and CWC conceived the study. HEW, SJS, and CWC designed the study. SJS and MDW abstracted the data. HEW, SJS, and MDW analyzed the data. HEW drafted the article, and all authors contributed substantially to its revision. HEW had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. HEW takes responsibility for the paper as a whole.

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. This study was supported by National Heart, Lung, and Blood Institute grant U01-HL077871. Dr. Wang received support from Clinical Scientist Development Award K08-HS013628 from the Agency for Health Care Research and Quality, Rockville, MD. The funders had no direct role in the design or execution of the study or the composition of the resulting article.

 Reprints not available from authors.

PII: S0196-0644(09)00534-4

doi: 10.1016/j.annemergmed.2009.05.024

Annals of Emergency Medicine
Volume 54, Issue 5 , Pages 645-652.e1 , November 2009

Article Tools

* Image Usage & Resolution