King LT-D use by urban basic life support first responders as the primary airway device for out-of-hospital cardiac arrest
Autor: | Steven Vandeventer, Jonathan R. Studnek, Kelly Gahan |
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Rok vydání: | 2011 |
Předmět: |
Male
medicine.medical_specialty Emergency Medical Services Urban Population medicine.medical_treatment Resuscitation education Emergency Nursing Manikins Out of hospital cardiac arrest First responder medicine Emergency medical services Intubation Intratracheal Humans Retrospective Studies medicine.diagnostic_test business.industry Basic life support Auscultation Equipment Design Middle Aged medicine.disease United States Pulse oximetry Emergency Medical Technicians Emergency medicine Emergency Medicine Airway management Female Medical emergency Cardiology and Cardiovascular Medicine business Airway Out-of-Hospital Cardiac Arrest |
Zdroj: | Resuscitation. 82(12) |
ISSN: | 1873-1570 |
Popis: | Objective The objective of this study was to compare the frequency of first attempt success between basic life support (BLS) first responder initiated King LT-D placement and paramedic initiated endotracheal intubation (ETI) among patients experiencing out-of-hospital cardiac arrest (OOHCA). Methods In 2009 a large, urban EMS agency modified their out-of-hospital, non-traumatic, cardiac arrest protocol from paramedic initiated ETI to first responder initiated King LT-D placement. This retrospective analysis of all adult, non-traumatic cardiac arrests occurred four months before and four months after protocol implementation. The outcome variable in this analysis was first attempt airway management success defined as placement of the device with end tidal CO 2 wave form or colorimetric color change, auscultation of bilateral breath sounds, and improved or normal pulse oximetry reading. The independent variable of interest was initial device utilized to secure the airway, King LT-D or ETI. Results There were 351 adult, non-traumatic OOHCAs with 184 patients (52.4%) enrolled during the ETI period and 167 (47.6%) during the King LT-D period. The frequency of first attempt success was 57.6% in the ETI group and 87.8% in the King LT-D group. Patients in the King LT-D group were significantly more likely to experience first attempt success versus standard ETI methods (OR 5.3; 95%CI 2.9–9.5). Conclusion In this analysis of OOHCA airway management, first attempt BLS King LT-D placement success exceeded that of first attempt paramedic ETI success. In addition, patients in the King LT-D group were more likely to have had an advanced airway attempted and to have had a successful advanced airway placed when multiple attempts were required. |
Databáze: | OpenAIRE |
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