Prehospital Supraglottic Airways: An NAEMSP Position Statement and Resource Document

Area of Science:

• Emergency Medicine
• Airway Management
• Medical Devices

Background:

• Supraglottic airway (SGA) devices are established tools for oxygenation and ventilation in prehospital settings.
• Despite decades of use, advancements in SGA technology and education continue to shape clinical practice.
• EMS clinicians frequently utilize SGAs for both primary and rescue airway management.

Purpose of the Study:

• To provide recommendations for the optimal use of supraglottic airway devices in emergency medical services (EMS).
• To guide EMS agencies in selecting appropriate SGA strategies based on resources, clinician skills, and practice settings.
• To emphasize best practices for SGA insertion, confirmation, and ongoing management.

Main Methods:

• Development of evidence-based recommendations by the National Association of EMS Physicians (NAEMSP).
• Review of current literature and clinical practices regarding SGA use in prehospital care.
• Consideration of advancements in SGA technology, education, and patient safety.

Main Results:

• SGAs are validated as effective primary or secondary airway interventions in EMS.
• Waveform capnography is strongly recommended for confirming and monitoring SGA placement.
• Conversion from SGA to endotracheal tube should be judicious, based on clinical assessment.

Conclusions:

• EMS agencies should adopt SGA strategies aligned with their resources and capabilities.
• Comprehensive training and continuous quality management are essential for proficient SGA use.
• Proper utilization of SGAs enhances patient outcomes in prehospital airway management.