EBQ:Japanese OHCA Prehospital Airway Management Trial

incomplete Journal Club Article

Hasegawa, K et al. "Association of Prehospital Advanced Airway Management With Neurologic Outcome and Survival in Patients With Out-of-Hospital Cardiac Arrest". JAMA. 2012. 309 (3)(187612):257–266.
PubMed Full text PDF

Clinical Question

Do patients with out of hospital cardiac arrest have more favorable neurological outcome with advanced airway management by EMS compared to conventional bag-valve-mask ventilation?

Both supraglottic and endotracheal intubation will be associated with more favorable neurologic outcomes.

Inclusion Criteria

• January 1, 2005 to December 31, 2010
• Japanese EMS database
• 18 years older who had out of hospital cardiac arrest
• Resuscitation was attempted by EMS and patient was transported to hospital

Exclusion Criteria

• no age recorded for cardiac arrest
• out of hospital airway records were not documented

Interventions

• advanced airway devices placed with either endotracheal intubation or supraglottic airway
• providers had 2 attempts to place airway
• advanced airway confirmed with end-tidal CO2 and/or esophageal detection device

Outcome

Primary Outcomes

*favorable neurological outcome at 1 month after cardiac arrest