Abstract
Objective
Respiratory Therapists (RTs) are some of the first staff to arrive at in-hospital
incidents where cardiopulmonary resuscitation (CPR) is needed, yet at some facilities,
their ability to intubate is limited by hospital scope of practice. During the intubation
process, CPR is often interrupted which could potentially increase the likelihood
of adverse patient outcomes. Training RTs to secure the airway using non-intubation
methods may reduce or eliminate time for CPR interruptions and allow for earlier continuous/uninterrupted
chest compressions.
Design
A pilot study was developed to assess the effectiveness of a new policy for RT scope
of practice.
Methods
RTs were trained for supraglottic airway device placement prior to procedure initiation.
After each device insertion event, RTs completed a written survey. Time between cardiac
arrest and device insertion, number of insertion attempts, ease of placement, technical
specifications of the device, complications, and survival were compiled and compared
between supraglottic airway device and endotracheal tube (ETT) placement.
Results
Procedural information from 23 patients who received a supraglottic airway device
during the trial was compared to retrospective data of CPR events requiring intubation
from the previous year. Time between initiation of cardiac arrest and advanced airway
placement decreased significantly (p < 0.0001) when RTs placed the supraglottic airway
device (4.7 min) versus ETT at CPR events the previous year (8.6 min). Device-associated
complications were minimal and patient mortality was the same regardless of device.
Conclusion
We propose that more RTs should be trained to insert supraglottic airway devices during
inpatient CPR events.
Keywords
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Article Info
Publication History
Published online: June 13, 2018
Accepted:
June 12,
2018
Received in revised form:
June 7,
2018
Received:
March 22,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
