The time required to perform different methods for endotracheal drug administration during CPR.

Abstract

We compared the times necessary to perform different endotracheal drug application techniques during CPR. In a simulated CPR situation with a mannequin 28 paramedics and seven emergency physicians performed different drug instillation techniques in a randomized manner: direct injection into the upper end of the endotracheal tube (group tube), via a suction catheter placed into the bronchial system (group suction catheter), via a flexible venous catheter placed into the bronchial system (group venous catheter), using an EDGAR tube (an endotracheal tube with an injection channel within the wall of the tube (group EDGAR). We measured the time necessary to prepare the drug solution and compared the time necessary to prepare and perform each instillation method and the time the ventilation was interrupted. Comparison between groups was performed by the Kruskal-Wallis test. It took significantly longer to perform the more complicated techniques using suction catheters (26; 18 54 s) and venous catheters (30; 22-50 s) compared to the other two groups (median; min-max) (p < 0.05). No differences concerning the application time were found between the group tube (7; 5 14 s) and group EDGAR (8; 5-13 s). The time of interruption of chest compression's and ventilation: group suction tube (11; 5-19 s) and group catheter (12; 6-18 s) was significant longer than in group tube (5; 2-9 s) (p < 0.05). In group EDGAR the connection ventilator-tube remained intact due to its concept of drug application. The use of special devices such as suction catheters or venous catheters for endotracheal instillation during CPR results in significantly longer preparation and instillation times with a longer interruption of the oxygen supply and chest compression's.