Effect of emergency medical technician-placed Combitubes on outcomes after out-of-hospital cardiopulmonary arrest.

Objective. While emergency medical technicians–basic (EMT-Bs) in select emergency medical services (EMS) agencies use the Esophageal Tracheal Combitube (ETC) for the airway management of out-of-hospital cardiopulmonary arrests, the effect of this intervention on patient outcomes is not known. We compared the associations between initial EMT ETC placement and initial paramedic endotracheal intubation (ETI) on patient survival after out-of-hospital cardiopulmonary arrest. Methods. We utilized data on adult (age > 21 years), out-of-hospital cardiopulmonary arrests from a large, urban, county-based, two-tiered (EMT-B first responder, paramedic ambulance) EMS system for the years 1997–2005. EMT-Bs placed an ETC on cardiopulmonary arrest patients if they arrived before paramedics. Paramedics managed the airway primarily using ETI. We included cases in which rescuers accomplished ETC insertion or ETI on the first airway effort. We excluded cases in which an invasive airway was not used. We excluded cases with fa...