Supraglottic airway device placement by respiratory therapists

Area of Science:

• Emergency Medicine
• Respiratory Care
• Critical Care

Background:

• Respiratory Therapists (RTs) are frontline responders during in-hospital cardiopulmonary resuscitation (CPR).
• Current hospital policies may limit RTs' ability to intubate, leading to CPR interruptions.
• Interruptions in CPR can negatively impact patient outcomes.

Purpose of the Study:

• To assess the effectiveness of a new policy expanding RT scope of practice for airway management.
• To evaluate the use of supraglottic airway devices by RTs during inpatient CPR.
• To compare outcomes between supraglottic airway device placement and traditional endotracheal tube (ETT) intubation.

Main Methods:

• A pilot study trained RTs in supraglottic airway device placement.
• Data collected included time to advanced airway, insertion attempts, ease of placement, complications, and survival.
• Procedural data from 23 patients using supraglottic airways were compared to retrospective ETT data.

Main Results:

• Time from cardiac arrest to advanced airway placement significantly decreased with RT-placed supraglottic airways (4.7 min) compared to ETTs (8.6 min).
• Device-associated complications were minimal.
• Patient mortality rates were comparable between the two airway management methods.

Conclusions:

• RTs should be trained to insert supraglottic airway devices during inpatient CPR.
• Expanding RT scope of practice for airway management can improve efficiency and potentially patient outcomes.
• Supraglottic airway devices offer a viable alternative to ETTs during CPR, reducing critical time delays.