Perception and success rate of using advanced airway management by hospital-based paramedics in the Kingdom of Saudi Arabia

2021 ◽  
Vol 6 (3) ◽  
pp. 24-30
Author(s):  
Amani Alenazi ◽  
Bashayr Alotaibi ◽  
Najla Saleh ◽  
Abdullah Alshibani ◽  
Meshal Alharbi ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Airway Management ◽  
Success Rate ◽  
Phase 1 ◽  
Adult Patients ◽  
Supraglottic Airway ◽  
Future Research ◽  
Phase 2 ◽  
Advanced Airway ◽  
Supraglottic Airway Devices

Objective: The study aimed to measure the success rate of pre-hospital tracheal intubation (TI) and supraglottic airway devices (SADs) performed by paramedics for adult patients and to assess the perception of paramedics of advanced airway management.Method: The study consisted of two phases: phase 1 was a retrospective analysis to assess the TI and SADs’ success rates when applied by paramedics for adult patients aged >14 years from 2012 to 2017, and phase 2 was a distributed questionnaire to assess paramedics’ perception of advanced airway management.Result: In phase 1, 24 patients met our inclusion criteria. Sixteen (67%) patients had TI, of whom five had failed TI but then were successfully managed using SADs. The TI success rate was 69% from the first two attempts compared to SADs (100% from first attempt). In phase 2, 63/90 (70%) paramedics responded to the questionnaire, of whom 60 (95%) completed it. Forty-eight (80%) paramedics classified themselves to be moderately or very competent with advanced airway management. However, most of them (80%) performed only 1‐5 TIs or SADs a year.Conclusion: Hospital-based paramedics (i.e. paramedics who are working at hospitals and not in the ambulance service, and who mostly respond to small restricted areas in Saudi Arabia) handled few patients requiring advanced airway management and had a higher competency level with SADs than with TI. The study findings could be impacted by the low sample size. Future research is needed on the success rate and impact on outcomes of using pre-hospital advanced airway management, and on the challenges of mechanical ventilation use during interfacility transfer.

Difficult Airway

2017 ◽  
Author(s):  
Romina G. Ilic
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Awake Intubation ◽  
Supraglottic Airway ◽  
Patient Evaluation ◽  
Advanced Airway ◽  
Supraglottic Airway Devices ◽  
Surgical Airway ◽  
Airway Exchange ◽  
Airway Devices

The difficult airway chapter focuses on preparing the clinician for a challenging airway. Management of both the expected, as well as the unexpected, difficult airway is critical to the care of the perioperative patient. Proper patient evaluation, organization, and preparation with a variety of airway tools are imperative to successfully securing the airway. The chapter reviews the difficult airway algorithm and discusses advanced airway techniques such as the use of awake intubation, airway exchange catheters, supraglottic airway devices, and surgical airway. Gaining familiarity with and using these advanced airway techniques in non-urgent situations will help ensure success when they are needed in emergencies.

scholarly journals A prospective observational study comparing two supraglottic airway devices in out-of-hospital cardiac arrest

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maja Pålsdatter Lønvik ◽  
Odd Eirik Elden ◽  
Mats Joakimsen Lunde ◽  
Trond Nordseth ◽  
Karin Elvenes Bakkelund ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Airway Management ◽  
Success Rate ◽  
Clinical Performance ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Ambulance Personnel ◽  
Increased Risk ◽  
Supraglottic Airway Devices ◽  
Hospital Cardiac Arrest

Abstract Background Airway management in patients with out of hospital cardiac arrest (OHCA) is important and several methods are used. The establishment of a supraglottic airway device (SAD) is a common technique used during OHCA. Two types of SAD are routinely used in Norway; the Kings LTS-D™ and the I-gel®. The aim of this study was to compare the clinical performance of these two devices in terms of difficulty, number of attempts before successful insertion and overall success rate of insertion. Methods All adult patients with OHCA, in whom ambulance personnel used a SAD over a one-year period in the ambulance services of Central Norway, were included. After the event, a questionnaire was completed and the personnel responsible for the airway management were interviewed. Primary outcomes were number of attempts until successful insertion, by either same or different ambulance personnel, and the difficulty of insertion graded by easy, medium or hard. Secondary outcomes were reported complications with inserting the SAD’s. Results Two hundred and fifty patients were included, of whom 191 received I-gel and 59 received LTS-D. Overall success rate was significantly higher in I-gel (86%) compared to LTS-D (75%, p = 0.043). The rates of successful placements were higher when using I-gel compared to LTS-D, and there was a significant increased risk that the insertion of the LTS-D was unsuccessful compared to the I-gel (risk ratio 1.8, p = 0.04). I-gel was assessed to be easy to insert in 80% of the patients, as opposed to LTS-D which was easy to insert in 51% of the patients. Conclusions Overall success rate was significantly higher and the difficulty in insertion was significantly lower in the I-gel group compared to the LTS-D in patients with OHCA.

scholarly journals Association between prehospital airway management methods and neurologic outcome in out-of-hospital cardiac arrest with respiratory cause: a nationwide retrospective observational study

2021 ◽  
Keyword(s):  
Cardiac Arrest ◽  
Airway Management ◽  
Interaction Analysis ◽  
Neurologic Outcome ◽  
Supraglottic Airway ◽  
Neurologic Recovery ◽  
Logistic Regression Models ◽  
Advanced Airway ◽  
Prehospital Airway Management ◽  
Hospital Cardiac Arrest

Cardiac arrests are resulted by various aetiology including respiratory cause. Advanced airway placement is an important prehospital intervention for oxygenation and ventilation in respiratory cardiac arrest. We evaluated the association between of advanced airway method and neurologic outcome in arrest with respiratory cause. Adult witnessed non-traumatic OHCA (out-of-hospital cardiac arrest) treated by emergency medical service (EMS) providers in 2013–2017 were enrolled in a nationwide OHCA database. The association between airway management methods (endotracheal intubation (ETI), supraglottic airway (SGA) and bag valve mask (BVM)) and outcome were evaluated according to the presumed cause of cardiac arrest (cardiac, respiratory or others). The primary outcome was good neurological recovery at discharge. Multivariable logistic regression models with interaction analysis was conducted. Of 40,443 eligible OHCA patients, the cause of arrest of 90.0%, 7.5%, and 2.4% of patients were categorized as cardiac, respiratory and others, respectively. There were no statistically significant differences in the effect of the advanced airway type on good neurologic recovery in the total population (adjusted odds ratio (aOR) 0.96 (0.81–1.14) for ETI; 1.01 (95% confidence intervals (CI) 0.93–1.11) for BVM). However, ETI was associated with better neurologic recovery than SGA or BVM in OHCA in cardiac arrest with suspected respiratory cause (aOR 3.12 (95% CI 1.24–7.80) for ETI; 0.99 (95% CI 0.51–1.91) for BVM). Prehospital ETI was associated with good neurologic outcome when the cause of arrest was respiratory. ETI may be considered initially when a respiratory cause is suspected on the scene.

The relationship between uses of music, musical taste, age, and life goals

2020 ◽  
pp. 030573562091524 ◽  
Author(s):  
Adrian North ◽  
Emily Hird
Keyword(s):  
Phase 1 ◽  
Theoretical Explanation ◽  
Life Goals ◽  
Chronological Age ◽  
Future Research ◽  
Phase 2 ◽  
Mixed Methods Approach ◽  
Musical Taste ◽  
Short Test ◽  
The Relationship

Musical taste and uses of music correlate with age, although there has been little theoretical explanation of these relationships. The present research argues that musical behavior may be explained by chronological age and variations in life goals across the lifespan, and investigated the relationship between life goals, age, musical taste, and uses of music using an exploratory mixed-methods approach. In Phase 1, thematic analysis of responses from 27 adults aged 65+ years allowed development of an improved “Uses of Music” questionnaire for use with adults of all ages. In Phase 2, 799 Australian adults aged 18–81 years completed three questionnaires, namely Uses of Music (amended), Short Test of Music Preference—Revised, and the GOALS Importance Subscale. Chronological age correlated with life goals; and chronological age, life goals, and musical taste predicted using music for each of social reasons, mood regulation, reminiscence, and activities. Future research on music should not regard age as simply a chronological variable, and instead acknowledge that it implies several life goals which themselves relate to musical taste and uses of music in different ways.

scholarly journals The Difficult Airway Trolley: A Narrative Review and Practical Guide

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Martin F. Bjurström ◽  
Mikael Bodelsson ◽  
Louise W. Sturesson
Keyword(s):  
Airway Management ◽  
Difficult Airway ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Future Research ◽  
Clinical Settings ◽  
Airway Equipment ◽  
National Expert ◽  
Airway Devices ◽  
Facemask Ventilation

Death and severe morbidity attributable to anesthesia are commonly associated with failed difficult airway management. When an airway emergency develops, immediate access to difficult airway equipment is critical for implementation of rescue strategies. Previously, national expert consensus guidelines have provided only limited guidance for the design and setup of a difficult airway trolley. The overarching aim of the current work was to create a dedicated difficult airway trolley (for patients>12 years old) for use in anesthesia theatres, intensive care units, and emergency departments. A systematic literature search was performed, using the PubMed, Embase, and Google Scholar search engines. Based on evidence presented in 11 national or international guidelines, and peer-reviewed journals, we present and outline a difficult airway trolley organized to accommodate sequential progression through a four-step difficult airway algorithm. The contents of the top four drawers correspond to specific steps in the airway algorithm (A = intubation, B = oxygenation via a supraglottic airway device, C = facemask ventilation, and D = emergency invasive airway access). Additionally, specialized airway equipment may be included in the fifth drawer of the proposed difficult airway trolley, thus enabling widespread use. A logically designed, guideline-based difficult airway trolley is a vital resource for any clinician involved in airway management and may aid the adherence to difficult airway algorithms during evolving airway emergencies. Future research examining the availability of rescue airway devices in various clinical settings, and simulation studies comparing different types of difficult airway trolleys, are encouraged.

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