Hao-Yang Lin

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

Study objective: The effect of out‐of‐hospital intubation in patients with out‐of‐hospital cardiac arrest remains controversial. The Taipei City paramedics are the earliest authorized to perform out‐of‐hospital intubation among Asian areas. This study evaluates the association between successful intubation and out‐of‐hospital cardiac arrest survival in Taipei. Methods: We analyzed 6 years of Utstein‐based registry data from nontrauma adult patients with out‐of‐hospital cardiac arrest who underwent out‐of‐hospital airway management including intubation, laryngeal mask airway, or bag‐valve‐mask ventilation. The primary analysis was intubation success on patient outcomes. The primary outcome was survival to discharge and the secondary outcomes included sustained return of spontaneous circulation and favorable neurologic survival. Sensitivity analysis was performed with intubation attempts rather than intubation success. Subgroup analysis of advanced life support–serviced districts was also performed. Results: A total of 10,853 cases from 2008 to 2013 were analyzed. Among out‐of‐hospital cardiac arrest patients receiving airway management, successful intubation, laryngeal mask airway, and bag‐valve‐mask ventilation was reported in 1,541, 3,099, and 6,213 cases, respectively. Compared with bag‐valve‐mask device use, successful out‐of‐hospital intubation was associated with improved chances of sustained return of spontaneous circulation (adjusted odds ratio [aOR] 1.91; 95% confidence interval [CI] 1.66 to 2.19), survival to discharge (aOR 1.98; 95% CI 1.57 to 2.49), and favorable neurologic outcome (aOR 1.44; 95% CI 1.03 to 2.03). The results were comparable in sensitivity and subgroup analyses. Conclusion: In nontrauma adult out‐of‐hospital cardiac arrest in Taipei, successful out‐of‐hospital intubation was associated with improved odds of sustained return of spontaneous circulation, survival to discharge, and favorable neurologic outcome.

The effect of different retraining intervals on the skill performance of cardiopulmonary resuscitation in laypeople—A three-armed randomized control study

AIM Our study aimed to compare cardiopulmonary resuscitation (CPR) performance among laypeople with different retraining intervals. METHODS Ninety-six non-medical university students were randomly allocated into 3 groups after receiving initial CPR and automated external defibrillator (AED) training. Sixty participants completed the study. The participants in the 3-, 6-, and 12-month groups received the same retraining every 3-, 6-, and 12 months. An 80-min retraining course comprised a video lecture and hands-on practice, with feedback from the instructors and the Resusci Anne® QCPR. The primary outcome was a skill pass rate one year post-initial training. The secondary outcomes included a skill pass rate prior to each retraining course, knowledge test scores, and individual skill performance evaluated by assessors and by SkillReporter® software one year post-initial training. RESULTS The characteristics among the groups were similar. The 3-month group had the highest pass rate (3-month group: 6-month group: 12-month group, 100.0%: 78.9%: 19.0%, p < 0.001) in the primary outcome. In secondary outcomes, the 3-month group had a higher pass rate than the 6-month group at 6 months post-initial training. The 3-month group achieved the highest knowledge test scores, and performed best in many ventilation items. They showed similar performance to the 6-month group and better performance than the 12-month group in chest compression items. The 3 groups performed similarly in AED manipulation. CONCLUSIONS Although young laypeople with a 3-month retraining interval had the highest pass rate when performing conventional CPR, a 6-month retraining interval may be considered for training compression-only CPR and AED when balancing outcomes and resources.