Prehospital Intubation or Bag-Valve-Mask Ventilation for Cardiac Arrest Patients?

Technicalities leave an ambitious study inconclusive, but results point toward equivalence of the two airway strategies.

There is debate about which airway management technique is best for out-of-hospital cardiac arrest (OHCA) patients in the prehospital setting: endotracheal intubation or bag-valve-mask (BVM) ventilation. Investigators randomized 2043 patients with OHCA in France and Belgium to one of the two techniques and analyzed the data using a noninferiority strategy; the prespecified noninferiority margin was 1%, meaning that the 95% confidence interval (CI) would have to exclude a 1% difference in the main outcome measure. A trained emergency physician was present for all resuscitations.

The main outcome, favorable functional survival at 28 days, was achieved by 4.3% of patients in the BVM group and 4.2% in the intubation group, for a risk difference …

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Prehospital Intubation or Bag-Valve-Mask Ventilation for Cardiac Arrest Patients?

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Reviewing Author