2 Comments

OHCA and advanced airways

More evidence for BVM only in OHCA…a study from Japan.

My thoughts: – the data supporting intra-arrest advanced airway management is looking pretty thin on the ground. The Japanese model of prehospital care is not similar to Australasian PHC models. Again, I don’t necessarily think that this study can be used as a basis for change to worldwide prehospital practice.

For example, for prehospital services that provide prehospital therapeutic cooling, ETI is essential. So I guess the question is, should such services consider BVM during arrest, and if ROSC is achieved, RSI or “cold tube” and then sedate/paralyse/cool? As far as I know, there aren’t many studies looking at advanced airway Mx in the ROSC/cooling component of overall OHCA management. The authors acknowledge that it is difficult to establish a link to prehospital advanced airway management and poor outcomes.

Anyway, this is a well designed study out of Japan. Have a look.

JAMA OHCA Advanced Airways

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2 comments on “OHCA and advanced airways

  1. Hey Ben, any studies you know of that discuss the time taken to perform the intubation process, therefore “Hands off the chest time”. potentially a key here. Quick search and I answered my own question, Wang 2008, Interruptions in Cardiopulmonary Resuscitation From Paramedic Endotracheal Intubations, found up to 1 min interruptions. I would like to suppose that the quality of training in intubation provided to the pre-hospital provider would have an impact here. Tim

    • Wang et al study a worry Tim. Use it in MICA lecture as the attempt ranged from 2 to 9 (!!!) in that study. Not reflective of our practice. So I agree that it’s dependent in education and training

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