Abstract 140: Comparison of CPR Quality Metrics Before and After Placement of Advanced Airways in Out-of-Hospital Cardiac Arrest
Background: The value and role of advanced airway placement (AAP) (tracheal intubation and supraglottic airways) during out-of-hospital cardiac arrest (OHCA) is debatable and little is known about the effect of AAP on chest compression (CC) quality. Both logistical factors and positive-pressure ventilation post-AAP may impact CC metrics. To evaluate this issue, we compared CPR quality metrics before and after AAP.
Objective: To determine if AAP is associated with changes in mean CC depth, rate, maximum force, or percentage of complete chest release during CPR.
Methods: From 644 OHCAs cared for by 3 EMS agencies, complete CC quality and CO2 waveform data (Philips HeartStart MRx defibrillators) were available from 149 cases (4/20/06-2/16/13). The time of AAP was identified by the appearance of a CO2 waveform. On each case, continuous CC episodes of ~2 min duration were visually identified pre- and post-AAP for computation of metrics and pair-wise comparison of mean values. To identify the pre-AAP quality metric period, selection preference was given to CC intervals ending at least 1 minute prior to the appearance of a CO2 waveform.
Results: The table shows the comparison of mean CC depth, rate, maximum force, and percentage of complete release pre- and post-AAP (paired t-test, α=0.05). No significant differences in depth, rate, maximum force, or percentage of complete release were identified.
Conclusion: In this preliminary study, no significant differences in four CPR quality metrics were identified after placement of an advanced airway. Future large, prospective studies are needed to clearly elucidate the potential influence of tracheal intubation and supraglottic airways, and the differences between them, on CPR quality.
- © 2013 by American Heart Association, Inc.