215 The Use of Ketamine in Prehospital Trauma Care

Objective: To evaluate the safety and effectiveness of the Combitube in the hands of intensive care unit nurses under medical supervision compared to the endotracheal airway in the hands of intensive care unit physicians during cardiopulmonary resuscitation.Methods: A prospective study of intensive care patients was performed over a seven-month period.Thirty-seven patients suffering from cardiac arrest were studied in a medical intensive care unit.Patients underwent emergency intubation with either the Combitube inserted by nurses or with the endotracheal airway introduced by physicians, and subsequent mechanical ventilation.Intubation time and blood gases were analyzed.Results: Intubation time was shorter with the Combitube (18.5 ±6.2 vs 27.2 ±7.3 seconds, p <.001).Evaluation of blood gases after 20 minutes of mechanical ventilation showed comparable results between both devices.The mean PaO 2 values were slightly higher during ventilation with the Combitube (123.5 ±19.6 vs 106.5 ±20.3 mmHg, /x.OOl). Conclusion:The Combitube in the hands of intensive care nurses was as effective as the endotracheal airway in the hands of intensivists during cardiopulmonary resuscitation.The Combitube may be used whenever endotracheal intubation cannot be performed immediately.215 The Use of Ketamine in Prehospital Trauma Care