033. Comparison of the Esophageal-Tracheal Combitube™ and Endotracheal Intubation in the Out-of-Hospital Management of Cardiac Arrest

Purpose: To determine whether the Esophageal-Tracheal Combitube™ (ETC) is a useful and effective alternative to endotracheal intubation in the out-of-hospital management of cardiac-arrest patients. The ETC is a double-lumen tube that can oxygenate, ventilate, and provide airway protection for a patient, following blind insertion into either the esophagus or trachea. Several in-hospital studies have demonstrated its effectiveness. Methods: A prospective, randomized experimental design was employed. The airway management of adult cardiac arrest victims treated by participating out-of-hospital providers was randomized to two treatment groups. On even-numbered days an endotracheal tube (ETT) was placed, and on odd-numbered days an ETC was used. Resuscitation then proceeded according to ACLS guidelines and local EMS protocols. Data concerning intubation success, ease of intubation, and arterial blood gas analysis were recorded and analyzed using unpaired t -tests and chi-square analyses. Results: Fifty patients were enrolled in the study. A comparison between treatment groups is outlined below: No statistically significant differences ( p Conclusions: This out-of-hospital study provides further evidence that the ETC is comparable to the ETT as measured by paramedic ease of use, intubation success rates, oxygenation, and ventilation. The ETC should be considered a useful and effective alternative to endotracheal intubation for out-of-hospital airway management.