ETI vs. SGA: The Verdict Is In

Engine 32 and Rescue 4 respond to a person not breathing at a youth sports complex. They arrive to see bystanders performing CPR and applying the facility’s automated external defibrillator (AED). While exiting the vehicle, paramedics hear the AED deliver a shock.
Because of the large crowd gathered around the patient, paramedics and EMTs quickly load the patient into the back of the ambulance. En route, one medic starts an IV line while the other attempts intubation.
The patient’s short neck and small mouth make the intubation effort very difficult. The medic attempts laryngoscopy three times, each time with a 45 second break in chest compressions as he attempts to visualize the vocal cords.
His partner steps in and inserts a laryngeal tube airway. Resuscitation is continued in the local ED for 30 minutes until the patient is declared dead. The two paramedics and the ED physician then debate the best airway management strategy for patients in cardiac arrest.
Background
Out-of-hospital cardiac arrest (OHCA) is a major public health problem affecting more than 424,000 persons annually in the United States, with only 10.4% surviving to discharge from the hospital.1
Endotracheal intubation (ETI) is one of most common procedures performed by paramedics during cardiac resuscitation; however, several research studies have highlighted the pitfalls of prehospital ETI, including misplacement of ET tubes and multiple failed intubation attempts.2
Intubation attempts may also interfe...

Source: JEMS Patient Care - August 30, 2018 Category: Emergency Medicine Authors: Shannon W. Stephens, EMT-P Tags: Airway & Respiratory Exclusive Articles Source Type: news