The Effect of Successful Intubation on Patient Outcomes After Out-of-Hospital Cardiac Arrest in Taipei

Chiang, Wen-Chu; Hsieh, Ming‐Ju; Chu, Hsin-Lan; Chen, Albert Y.; Wen, Shin-Yi; Yang, Wen-Shuo; Chien, Yu-Chun; Wang, Yaocheng; Lee, Bin-Chou; Wang, Huei-Chih; Huang, Edward Pei-Chuan; Yang, Chih‐Wei; Sun, Jen‐Tang; Chong, Kah-Meng; Lin, Hao-Yang; Hsu, Shun-Chin; Chen, Shey-Ying; Huei‐Ming, Matthew

doi:10.1016/j.annemergmed.2017.08.008

Cited by 34 publications

(26 citation statements)

References 21 publications

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“…2 Not applicable indicates that the intervention was already realized by the supervisor. 3 Percentage of patients transported to the emergency department (ED). 4 Percentage of attempted intubations.…”

Section: Resultsmentioning

confidence: 99%

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Endotracheal Intubation Success Rate in an Urban, Supervised, Resident-Staffed Emergency Mobile System: An 11-Year Retrospective Cohort Study

Chan

Fehlmann

Pasquier

et al. 2020

JCM

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Objectives: In the prehospital setting, endotracheal intubation (ETI) is sometimes required to secure a patient’s airways. Emergency ETI in the field can be particularly challenging, and success rates differ widely depending on the provider’s training, background, and experience. Our aim was to evaluate the ETI success rate in a resident-staffed and specialist-physician-supervised emergency prehospital system. Methods: This retrospective study was conducted on data extracted from the Geneva University Hospitals’ institutional database. In this city, the prehospital emergency response system has three levels of expertise: the first is an advanced life-support ambulance staffed by two paramedics, the second is a mobile unit staffed by an advanced paramedic and a resident physician, and the third is a senior emergency physician acting as a supervisor, who can be dispatched either as backup for the resident physician or when a regular Mobile Emergency and Resuscitation unit (Service Mobile d’Urgence et de Réanimation, SMUR) is not available. For this study, records of all adult patients taken care of by a second- and/or third-level prehospital medical team between 2008 and 2018 were screened for intubation attempts. The primary outcome was the success rate of the ETI attempts. The secondary outcomes were the number of ETI attempts, the rate of ETI success at the first attempt, and the rate of ETIs performed by a supervisor. Results: A total of 3275 patients were included in the study, 55.1% of whom were in cardiac arrest. The overall ETI success rate was 96.8%, with 74.4% success at the first attempt. Supervisors oversaw 1167 ETI procedures onsite (35.6%) and performed the ETI themselves in only 488 cases (14.9%). Conclusion: A resident-staffed and specialist-physician-supervised urban emergency prehospital system can reach ETI success rates similar to those reported for a specialist-staffed system.

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Section: Resultsmentioning

confidence: 99%

“…In the prehospital setting, endotracheal intubation (ETI) is often required to secure the patient's airways [1]. An ETI is indicated in various conditions, including cardiac arrest (CA) [2][3][4][5][6], respiratory distress refractory to standard treatment [7,8], coma and traumatic injuries [9,10].…”

Section: Background and Importancementioning

confidence: 99%

Endotracheal Intubation Success Rate in an Urban, Supervised, Resident-Staffed Emergency Mobile System: An 11-Year Retrospective Cohort Study

Chan

Fehlmann

Pasquier

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…They found a negative association between the use of an advanced airway and return of spontaneous circulation, survival, and neurologic outcome. In 2018, Chiang et al published the results of their retrospective study of out‐of‐hospital cardiac arrest data in Taipei City, Taiwan, covering a 6‐year period. They found that patients who were intubated successfully in the out‐of‐hospital setting were more likely to survive to discharge and had better neurologic status at discharge.…”

Section: Discussionmentioning

confidence: 99%

The Use of Transesophageal Echocardiography During Cardiac Arrest Resuscitation: A Literature Review

Parker

Salerno

Euerle

2018

J of Ultrasound Medicine

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We propose that transesophageal echocardiography (TEE) can be used to guide cardiac arrest resuscitation. We undertook a literature search (Medline and EMBase) to assess articles on that topic. Our search yielded 55 articles falling into 3 categories: TEE used in operating rooms, TEE used in emergency departments, and TEE used in other settings. In many cases, TEE changed the direction of the resuscitation; however, it is unclear whether TEE changed patient‐oriented outcomes, such as neurologically intact survival. Few adverse events related to TEE have been documented. There is growing evidence that physicians can learn to use TEE during resuscitations and apply the findings to clinical decisions.

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“…The city is a metropolitan area stretching over 272 km 2 with 2.65 million registered residents and an additional 3.0 million inflow daytime workers. The EMS system in the city is a mixed one-tier and two-tier fire-based system 21 22. Around 30% of stroke patients in the city arrive at the hospital via the EMS 23.…”

Section: Methodsmentioning

confidence: 99%

Using G-FAST to recognize emergent large vessel occlusion: a training program for a prehospital bypass strategy

Chiu

Tang

Sun

et al. 2019

J NeuroIntervent Surg

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IntroductionThe shorter the time between the onset of symptoms and reperfusion using endovascular thrombectomy, the better the functional outcome of patients. A training program was designed for emergency medical technicians (EMTs) to learn the gaze-face-arm-speech-time test (G-FAST) score for initiating a prehospital bypass strategy in an urban city. This study aimed to evaluate the effect of the training program on EMTs.MethodsAll EMTs in the city were invited to join the training program. The program consisted of a 30 min lecture and a 20 min video which demonstrated the G-FAST evaluation. The participants underwent tests before and after the program. The tests included (1) a questionnaire of knowledge, attitudes, confidence, and behaviors towards stroke care; and (2) watching 10 different scenarios in a video and answering questions, including eight sub-questions of G-FAST parameters, and choosing a suitable receiving hospital.ResultsIn total, 1058 EMTs completed the training program. After the program, significant improvement was noted in knowledge, attitudes, and confidence, as well as scenario judgement. The performance of the EMTs in evaluating G-FAST criteria in comatose patients was relatively poor in the pre-test and improved significantly after the training course. Although the participants answered the G-FAST items correctly, they tended to overtriage the patients and refer them to higher-level hospitals.ConclusionsA short training program can improve the ability to identify stroke patients and choose a suitable receiving hospital. A future training program could put further emphasis on how to evaluate comatose patients and choose a suitable receiving hospital.

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The Effect of Successful Intubation on Patient Outcomes After Out-of-Hospital Cardiac Arrest in Taipei

Cited by 34 publications

References 21 publications

Endotracheal Intubation Success Rate in an Urban, Supervised, Resident-Staffed Emergency Mobile System: An 11-Year Retrospective Cohort Study

Endotracheal Intubation Success Rate in an Urban, Supervised, Resident-Staffed Emergency Mobile System: An 11-Year Retrospective Cohort Study

The Use of Transesophageal Echocardiography During Cardiac Arrest Resuscitation: A Literature Review

Using G-FAST to recognize emergent large vessel occlusion: a training program for a prehospital bypass strategy

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