![]() ![]() In children receiving CPR, TI should be performed without pausing chest compressions. Procedural outcomes were not significantly different between attempts with and without compressions paused. TI during pediatric CPR results in significant interruptions in chest compressions. 25/32 (78%) of pauses exceeded 10seconds in duration. Laryngoscopy time was not significantly different between TI attempts with (47☒1 s) and without (47☒6 s p=0.2) interruptions in compressions. TI attempts without interruption in CPR were successful in 20/32 (63%) compared to 11/27 (41%) when CPR was paused (p=0.09). 32/59 (54%) TI attempts had an associated interruption in CPR the median interruption duration was 25 s (range 3-64 s). Median laryngoscopy time was 47seconds (range 8-115seconds). Overall first attempt success at TI was 15/32 (47%) a median of 2 attempts were made per patient (range 1 to 4). Data on intubation attempts (success, laryngoscopy time) and chest compressions (interruptions, duration of pauses) were collected.īetween December 2012 and February 2014, 32 patients had 59 TI attempts performed during CPR. Background data included patient age and training background of intubator. Intubations done by methods other than direct laryngoscopy were excluded. ![]() Children who underwent TI while receiving chest compressions were eligible for inclusion. Resuscitations in a pediatric ED are videorecorded for quality improvement. To describe procedural characteristics of tracheal intubation (TI) during cardiopulmonary resuscitation (CPR) in a pediatric emergency department, and to characterize interruptions in CPR associated with TI performance. Among discharged patients, the distribution of cerebral performance category scores was more favorable in the postintervention period (P<0.0001).Ī multifaceted protocol, including several American Heart Assocation best practices for the resuscitation of patients with OHCA, was associated with improved survival and neurological outcome. The univariate odds ratio or the association between neurologically intact survival (cerebral performance category 1 and 2) and protocol implementation was 2.3 (95% CI 1.4 to 3.7, P=0.001). Among patients who survived to hospital admission, a higher proportion in the postintervention period survived to hospital discharge (71/141 versus 36/98, P=0.037) and had a favorable neurological outcome (65 versus 25, P=0.0005) compared with patients treated before the protocol changes. In the postintervention period, there were 407 cardiac arrests with 65 neurologically intact survivors (16%), compared with 330 cardiac arrests with 25 neurologically intact survivors (8%) in the preintervention period. Prospectively collected data on patient survival and neurological outcome for all OHCAs were compared. Victims were directed to ST‐elevation myocardial infarction receiving centers. #HIGH QUALITY CPR PAUSES IN COMPRESSION OFFLINE#In September 2011, Salt Lake City Fire Department EMS providers underwent a systemwide restructuring of care for OHCA patients that focused on the adoption of high‐quality CPR with minimal interruptions and offline medical review of defibrillator data and feedback on CPR metrics. We hypothesized that the adoption of multiple best practices to focus EMS crews on high‐quality, minimally interrupted cardiopulmonary resuscitation (CPR) would improve survival of OHCA patients in Salt Lake City. Survival from out‐of‐hospital cardiac arrest (OHCA) varies by community and emergency medical services (EMS) system. ![]()
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