Prehospital Mechanical Ventilation: An NAEMSP Position Statement and Resource Document.

Area of Science:

• Emergency Medicine
• Critical Care
• Respiratory Therapy

Background:

• Airway emergencies and respiratory failure are common in prehospital settings.
• Manual ventilation during advanced airway management carries risks like hypo/hyperventilation and barotrauma.
• Portable mechanical ventilators offer a solution to optimize ventilation and minimize complications.

Purpose of the Study:

• To advocate for the use of mechanical ventilation in prehospital advanced airway management.
• To highlight the benefits of mechanical ventilation over manual methods in emergency medical services (EMS).
• To emphasize the need for specialized training and disease-specific protocols for prehospital mechanical ventilation.

Main Methods:

• Review of current prehospital airway management practices.
• Discussion of the advantages of mechanical ventilation in emergency settings.
• Emphasis on the importance of training and protocol adherence for EMS clinicians.

Main Results:

• Manual ventilation is linked to significant complications.
• Mechanical ventilation offers improved control over tidal volumes and ventilation parameters.
• Portable ventilators are a viable option for prehospital advanced airway management.

Conclusions:

• EMS clinicians should consider mechanical ventilation post-advanced airway insertion.
• Prehospital mechanical ventilation strategies must be disease-specific and align with in-hospital practices.
• Adequate sedation, analgesia, and comprehensive training are crucial for safe and effective prehospital mechanical ventilation.