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Cardiac arrest
ITDs in OHCA: early wins, late losses
Outcomes Following Impedance Threshold Device Use During Out-of-Hospital Cardiac Arrest
Resuscitation · 2026-10 · Added 10 October 2026
A 97,439-patient US national EMS sample found impedance threshold device use was associated with better prehospital ROSC (aOR 1.09) but lower survival to discharge (23.9% vs 32.0%, aOR 0.68), with even more extreme trends when combined with active compression-decompression.
- Study type
- Registry
- Design
- Retrospective national EMS registry analysis
- Participants
- 97,439 adults with non-traumatic OHCA
- Main finding
- ITD-only: ROSC 26.7% vs 23.8% (aOR 1.09) but survival to discharge 23.9% vs 32.0% (aOR 0.68), with worse neurological outcomes; ITD+ACD showed more extreme versions of both trends
- Caveat
- Only 23.3% of patients had disposition outcomes available, and device use was not randomised
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). Impedance threshold devices aren't carried by every Australian service, so this informs the device debate more than day-to-day practice — but the questions apply wherever they are used.
Learning goal
Weigh the risks and benefits of impedance threshold devices during out-of-hospital cardiac arrest resuscitation.
More
- Topic: Cardiac arrest
- Daily scan: 10 October 2026
- Podcast: Paramedic Papers Daily, 10 October 2026
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