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Comparison of tracheal intubation and alternative airway techniques performed in the prehospital setting by paramedics: a systematic review

Published online by Cambridge University Press:  21 May 2015

Jan L. Jensen ,
Ka Wai Cheung ,
John M. Tallon  and
Andrew H. Travers
Jan L. Jensen*
Affiliation:
Division of Emergency Medical Services, Dalhousie University, Dartmouth, NS Emergency Health Services, Dartmouth, NS
Ka Wai Cheung
Affiliation:
Emergency Department, Vancouver General Hospital, Vancouver, BC
John M. Tallon
Affiliation:
Division of Emergency Medical Services, Dalhousie University, Dartmouth, NS
Andrew H. Travers
Affiliation:
Emergency Health Services, Office of the Provincial Medical Director, Dartmouth, NS
*
Emergency Medical Services, QEII Health Sciences Centre, 1796 Summer St., Rm. 3022, Halifax NS B3H 3A7; jljensen@dal.ca

Abstract

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This systematic review included controlled clinical trials comparing tracheal intubation (TI) with alternative airway techniques (AAT) (bag-mask ventilation and use of extraglottic devices) performed by paramedics in the prehospital setting. A priori outcomes to be assessed were survival, neurologic outcome, airway management success rates and complications. We identified trials using EMBASE, MEDLINE, CINAHL, The Cochrane Library, Web of Science, author contacts and hand searching. We included 5 trials enrolling a total of 1559 patients. No individual study showed any statistical difference in outcomes between the TI and AAT groups. Because of study heterogeneity, we did not pool the data. This is the most comprehensive review to date on paramedic trials. Owing to the heterogeneity of prehospital systems, administrators of each system must individually consider their airway management protocols.

Keywords

paramedicprehospitalairwaytracheal intubationextraglotticsupraglotticbag-mask ventilation
Type
State of the Art • À la fine pointe
Information
Canadian Journal of Emergency Medicine , Volume 12 , Issue 2 , March 2010 , pp. 135 - 140
Copyright
Copyright © Canadian Association of Emergency Physicians 2010

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