CARING FOR THE CRITICALLY ILL PATIENT Association of Prehospital Advanced Airway Management With Neurologic Outcome and Survival in Patients With Out-of-Hospital Cardiac Arrest

OUT-OF-HOSPITAL CARDIAC arrest (OHCA) is a major public health problem, occurring in 375 000 to 390 000 individuals in the United States each year. The rate of survival after OHCA has increased with advances in care via initiatives such as the American Heart Association’s 5-step Chain of Survival. However, the rate is still low, with recent estimates reporting 8% to 10%. Better survival has been associated with the improvement in early access to emergency medical care, early cardiopulmonary resuscitation (CPR), rapid defibrillation, and integrated post– cardiac arrest care. Early advanced life support is often considered of benefit in that it provides intravenous drug therapy and advanced airway management. Although advanced airway management, such as endotracheal intubation or insertion of supraglottic airways, has long been the criterion standard for airway management of patients with OHCA, recent studies have challenged the survival benefit of advanced airway management compared with conventional bag-valvemask ventilation in this clinical