Advanced cardiac life support before and after tracheal intubation—direct measurements of quality

摘要: Summary Study hypothesis Tracheal intubation should improve the quality of cardiopulmonary resuscitation (CPR) by enabling adequate ventilation without pauses in external chest compressions. Methods Out-of-hospital cardiac arrests all causes were sampled this non-randomized, observational study advanced life support three ambulance services (Akershus, London and Stockholm). Prototype defibrillators (Heartstart 4000SP, Philips Medical Systems, Andover, MA, USA Laerdal AS, Stavanger, Norway) registered compressions via an extra pad with accelerometer mounted over lower part sternum ventilations from changes transthoracic impedance between standard defibrillator pads. The CPR was analyzed off-line for 119 episodes. Numbers differences are given as mean ± S.D. mean 95% confidence intervals. Results Chest not arrest 61 ± 20% time before compared to 41 ± 18% after (difference: 20% (16–24%)). Compressions per minute increased 47 ± 25 71 ± 23 24 (19, 29)) 5.6 ± 3.7 14 ± 5.0 8.7 (7.6, 9.8)) respectively. Four cases unrecognized oesophageal (3%) suspected disappearance induced thoracic intubation. Conclusion improved tracheal intubation, but fraction blood flow still high according international guidelines. On-line analysis might be a practicable aid avoid area needs further research.