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Updates in emergency airway management.

Jestin N Carlson1, Henry E Wang2

  • 1Department of Emergency Medicine, Allegheny Health Network, Erie, Pennsylvania.

Current Opinion in Critical Care
|September 22, 2018
PubMed
Summary

New trials show bougie-facilitated intubation improves first-attempt success. For out-of-hospital cardiac arrest, supraglottic airways offer better outcomes than endotracheal intubation.

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Area of Science:

  • Emergency Medicine
  • Critical Care
  • Airway Management

Background:

  • Evidence for emergency airway management historically relied on limited data.
  • Recent large randomized clinical trials provide new insights.

Purpose of the Study:

  • To review recent findings in emergency airway management.
  • To inform clinical practice based on new evidence.

Main Methods:

  • Review of recent large randomized clinical trials.
  • Analysis of data comparing different airway management techniques.

Main Results:

  • Bougie-facilitated intubation demonstrated higher first-attempt success rates compared to traditional methods.
  • Supraglottic airways (SGA) showed better outcomes in out-of-hospital cardiac arrest (OHCA) compared to endotracheal intubation.
  • Bag-valve mask ventilation in OHCA did not differ in outcomes but had higher aspiration rates than endotracheal intubation.

Conclusions:

  • Consider bougie-facilitated intubation as a first-line approach for emergency intubation.
  • Utilize SGA-based strategies as a first-line approach for managing OHCA.
  • New evidence supports specific airway management techniques in critical care settings.