Document Detail

King LT-D Use by Urban Basic Life Support First Responders as the Primary Airway Device for Out-of-Hospital Cardiac Arrest.
MedLine Citation:
PMID:  21756859     Owner:  NLM     Status:  Publisher    
Objective: The objective of this study was to compare the frequency of first attempt success between basic life support (BLS) first responder initiated King LT-D placement and paramedic initiated endotracheal intubation (ETI) among patients experiencing out-of-hospital cardiac arrest (OOHCA). Methods: In 2009 a large, urban EMS agency modified their out-of-hospital, non-traumatic, cardiac arrest protocol from paramedic initiated ETI to first responder initiated King LT-D placement. This retrospective analysis of all adult, non-traumatic cardiac arrests occurred four months before and four months after protocol implementation. The outcome variable in this analysis was first attempt airway management success defined as placement of the device with end tidal CO2 wave form or colorimetric color change, auscultation of bilateral breath sounds, and improved or normal pulse oximetry reading. The independent variable of interest was initial device utilized to secure the airway, King LT-D or ETI. Results: There were 351 adult, non-traumatic OOHCAs with 184 patients (52.4%) enrolled during the ETI period and 167 (47.6%) during the King LT-D period. The frequency of first attempt success was 57.6% in the ETI group and 87.8% in the King LT-D group. Patients in the King LT-D group were significantly more likely to experience first attempt success versus standard ETI methods (OR 5.3; 95% CI 2.9-9.5). Conclusion: In this analysis of OOHCA airway management, first attempt BLS King LT-D placement success exceeded that of first attempt paramedic ETI success. In addition, patients in the King LT-D group were more likely to have had an advanced airway attempted and to have had a successful advanced airway placed when multiple attempts were required.
Kelly Gahan; Jonathan R Studnek; Steven Vandeventer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-11
Journal Detail:
Title:  Resuscitation     Volume:  -     ISSN:  1873-1570     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-7-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ireland Ltd.
Carolinas Medical Center, Department of Emergency Medicine, Charlotte, North Carolina, USA.
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