ETI vs. SGA: The Verdict Is In

This study had several important limitations. The EMS agencies that participated in this trial have many years of experience in OHCA research, including additional training on CPR quality performance. As previously noted, due to limitations in funding, we couldn’t assess the influence of CPR quality. We studied a relatively limited number of out-of-hospital and in-hospital adverse events. It also wasn’t possible to blind EMS providers to treatment assignment. Although randomization was uneven in two sites, the overall characteristics of the study groups were similar. We observed a lower than expected ETI success rate; the potential for different outcomes with a higher ETI success rate remains a possibility. Many EMS agencies have recently switched to an alternative SGA, the i-gel. A similar trial called “The Airways-2 Randomized Clinical Trial” in the United Kingdom compared i-gel with intubation in OHCA.9  Their findings suggest that there are no significant differences at hospital discharge or 30 days after arrest for all trial patients.15 The Bottom Line PART found that initial airway management with the King LT was associated with significantly better clinical outcomes than initial ETI in adult OHCA. The authors recommend that EMS providers review the full results of the study, published in the Journal of the American Medical Assocation, with their medical director and strongly consider a strategy of initial King LT when treating adult OHCA.14 References 1. C...
Source: JEMS Special Topics - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Exclusive Articles Source Type: news