When a patient arrests, our instinct may be: “Airway first, tube now”. But evidence is building that an advanced airway placed too early, or placed while compressions are compromised, may actually reduce ROSC and survival. What the Studies Show A large observational cohort of adult in-hospital cardiac arrest patients found that tracheal intubation within the first 15 minutes of arrest was associated with lower ROSC and lower survival to discharge compared with delayed or no intubation. ROSC: 59.