A new study showed that a change in the type of breathing tube paramedics use to resuscitate patients with sudden cardiac arrest can significantly improve the odds of survival and save thousands of lives. More than 90 percent of Americans who experience sudden cardiac arrest die before, or soon after, reaching a hospital.
Funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health, this study is the largest of its kind to test oxygen delivery methods used by firefighters, emergency medical service (EMS) providers and paramedics. It is the first to show that a particular airway intervention can positively affect patient survival rates. The findings were published online in the Journal of the American Medical Association.
EMS providers treat the majority of the 400,000 out-of-hospital cardiac arrests each year. For more than three decades, their standard-of-care technique for resuscitation has been endotracheal intubation — the insertion of a plastic tube into the trachea to maintain an open airway. They use this technique in hopes that mirroring the care given by in-hospital physicians will produce better patient outcomes.
New devices such as laryngeal tubes, offer simpler alternatives to opening and accessing an airway. These tubes are easier to use, and the trial showed that cardiac arrest patients treated with this alternative had a higher survival rate.
Usually caused by a heart attack, sudden cardiac arrest occurs when the heart suddenly or unexpectedly stops beating, cutting off blood flow to the brain and other vital organs. The vast majority of out-of-hospital cardiac arrests occur at home, and only about 10 percent of people survive, according to the American Heart Association.
The Pragmatic Airway Resuscitation Trial was a multicenter research study conducted by the Resuscitation Outcomes Consortium(link is external). It compared survival rates among 3,000 adults with cardiac arrest who were treated by paramedic crews from 27 EMS agencies, in Birmingham, Alabama; Dallas-Fort Worth; Milwaukee; Pittsburgh; and Portland, Oregon. Approximately half of the patients received the newer laryngeal tube treatment, while the other half received traditional endotracheal intubation.
