Do Not Pardon the Interruption

Bobrow, Bentley J.; Spaite, Daniel W.

doi:10.1016/j.annemergmed.2009.06.508

Cited by 8 publications

(1 citation statement)

References 22 publications

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“…Some of them have been high-quality randomized controlled trials, moving the science of resuscitation forward and changing established algorithms and resuscitation protocols. The main finding arising from these studies is that, in OHCA of cardiac origin in adults, significantly interrupting chest compressions for the purposes of advanced airway management have a negative impact on patient survival and neurological outcome [36, 99]. These findings have prompted changes in BLS of adult patients with OHCA of nontraumatic origin.…”

Section: Discussionmentioning

confidence: 99%

Oxygenation, Ventilation, and Airway Management in Out-of-Hospital Cardiac Arrest: A Review

Henlín

Michálek

Tyll

et al. 2014

BioMed Research International

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Recently published evidence has challenged some protocols related to oxygenation, ventilation, and airway management for out-of-hospital cardiac arrest. Interrupting chest compressions to attempt airway intervention in the early stages of OHCA in adults may worsen patient outcomes. The change of BLS algorithms from ABC to CAB was recommended by the AHA in 2010. Passive insufflation of oxygen into a patent airway may provide oxygenation in the early stages of cardiac arrest. Various alternatives to tracheal intubation or bag-mask ventilation have been trialled for prehospital airway management. Simple methods of airway management are associated with similar outcomes as tracheal intubation in patients with OHCA. The insertion of a laryngeal mask airway is probably associated with worse neurologically intact survival rates in comparison with other methods of airway management. Hyperoxemia following OHCA may have a deleterious effect on the neurological recovery of patients. Extracorporeal oxygenation techniques have been utilized by specialized centers, though their use in OHCA remains controversial. Chest hyperinflation and positive airway pressure may have a negative impact on hemodynamics during resuscitation and should be avoided. Dyscarbia in the postresuscitation period is relatively common, mainly in association with therapeutic hypothermia, and may worsen neurological outcome.

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Section: Discussionmentioning

confidence: 99%