A recent study conducted by The Ohio State University College of Medicine has shed light on the changing trends in how paramedics assist individuals with breathing difficulties before they reach the hospital. Published in JAMA Network Open, the research focuses on the airway management practices of emergency medical services (EMS) in the United States, particularly in life-threatening situations such as cardiac arrest, trauma, and respiratory failure.
Lead author and clinical professor of emergency medicine, Henry Wang, emphasized the critical role of paramedics and emergency medical technicians in providing immediate medical care to critically ill patients. Understanding EMS airway management practices is essential for hospitals to effectively transition patients from the ambulance and address any potential complications.
The study analyzed EMS data from the ESO Data Collaborative, one of the largest EMS electronic health systems in the U.S., covering patient encounters from 2011 to 2022 where advanced airway management techniques were employed, including endotracheal intubation (ETI) and supraglottic airways (SGA).
Traditionally, ETI has been the primary method for assisting patients with breathing difficulties, involving the insertion of a tube through the mouth and vocal cords into the lungs. However, over the past decade, there has been a notable increase in the use of SGA devices for cardiac arrest patients. These simpler devices, which sit above the vocal cords, have become the preferred choice for managing cardiac arrest cases due to their ease of use and effectiveness.
The study revealed that SGA attempts surpassed ETI attempts in cardiac arrest cases between 2020 and 2022, marking a significant shift in EMS airway management practices. Wang explained that SGAs are considered faster and simpler to use, with similar ventilation outcomes compared to ETI, requiring less training.
The research, which analyzed over 40 million EMS activations for medical emergencies, highlighted the increasing preference for SGA over ETI across different types of emergency cases, including cardiac arrest, non-cardiac arrest medical events, and trauma incidents.
Wang emphasized the importance of understanding these national EMS clinical practices to optimize emergency resource allocation and enhance training protocols. Ongoing research led by Wang is focused on determining the most effective advanced airway management techniques for children through the Pediatric Prehospital Airway Resuscitation Trial.
The study, titled “Longitudinal Changes in Emergency Medical Services Advanced Airway Management,” provides valuable insights into the evolving landscape of EMS airway management practices. It underscores the need for continuous assessment and adaptation of emergency medical protocols to ensure the best possible outcomes for patients in critical situations.
