Available online 2 June 2022

Patients experiencing out-of-hospital cardiac arrest are often intubated for the purpose of airway management, but unsuccessful intubation can negatively impact patient care. Relatively little research has examined intubation success as a factor of patient demographic characteristics.

We examined out-of-hospital cardiac arrests within a nationwide database of EMS runs in the United States and found female patients and White patients are associated with significantly higher intubation success than male patients and non-White patients.

Possible explanations include differences in patient health, differences in provider familiarity with intubation, and differences in the availability of assistive technologies that facilitate easy intubation. Further studies should continue to closely examine cardiac arrest disparities with the goal of identifying ways to eliminate them.

Tracheal intubation is a high-risk procedure often performed in the prehospital setting by emergency medical services (EMS) on patients experiencing cardiac arrest. Because of the high potential for adverse consequences resulting from unsuccessful intubation, intubation success rates are a topic of significant concern. There has been little research examining whether cardiac arrest intubation success rates vary based on patient race/ethnicity and patient sex.

We examined a national registry of EMS calls in the United States. Inclusion criteria were tracheal intubations (2017–2021) performed on adult cardiac arrest patients where EMS providers documented the patient's race/ethnicity and patient sex and whether the intubation was successful. A total of 210,992 cardiac arrests met inclusion criteria. When considering patient sex, intubation was more common in male patients than female patients, but intubation success rates were significantly higher in female patients (p < .01). When considering patient race/ethnicity, intubation success rates were highest in White patients and significantly lower in patients of all other races/ethnicities (p < .01).

Intubation success rates were higher in female patients and White patients. Further studies need to examine disparities and identify strategies to improve intubation success for all patients with cardiac arrest. Possible explanations for the obtained results are differences in patient health, in provider familiarity with intubation, and in the availability of assistive technologies that facilitate intubation (e.g. video laryngoscopy).

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