title: Time to intubation and survival in prehospital cardiac arrest.
abstract: OBJECTIVE
  To examine the correlation between time to paramedic intubation and survival after prehospital cardiac arrest.
  
  
  METHODS
  This was a retrospective cohort study of 693 patients who had paramedic endotracheal intubation for prehospital cardiac arrest in King County, Washington (excluding Seattle), between January 1991 and May 2003. Based on the time from patient collapse until intubation, cases were divided into quartiles. Survival in the slower three quartiles (defined as "slow intubation") was compared with survival in the fastest quartile (defined as "quick intubation").
  
  
  RESULTS
  In the quick intubation group (intubation time < or = 12 minutes), 46% of the patients survived; in the slow intubation group (intubation time > or = 13 minutes), 23% of the patients survived. Logistic regression was used to adjust for possible confounders that affect survival: age, gender, location, bystander cardiopulmonary resuscitation, cardiac rhythm, emergency medical technician response time, and paramedic response time. The fully adjusted odds ratio of survival for the slow intubation group compared with the quick intubation group was 0.42 (95% confidence interval 0.26, 0.69).
  
  
  CONCLUSIONS
  This study is the first of its kind to compare survival with the time interval until an aspect of advanced life support is performed. These findings suggest that faster intubation times may increase odds of survival in prehospital cardiac arrest. Future prospective studies are merited to further understand this association.
authors.affiliation: School of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Bradley D
authors.initials: BD
authors.lastname: Shy
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Rea
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Becker
authors.forename: Mickey S
authors.initials: MS
authors.lastname: Eisenberg
mesh_terms: D000368:Aged; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal; D016015:Logistic Models; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014861:Washington / Q000453:epidemiology