Last year the US Department of Health launched the possibility to healthcare workers and scientific community members to comment and leave questions on how to improve prehospital airway management. Here is the systematic review issued in February 2020.

The core dilemma in prehospital care is to match the best patient outcome with airway management technique and the resources available. Considering patient needs means considering the patient’s condition, as the severity of illness or injury, the location/environment and the available equipment and personnel. The most seriously ill or injured patients seen in the ED arrive through EMS.

That’s why the improvement of EMS system capacities, including the availability of data collection and information integration, is very important. Guideline developers and EMS system leaders want to use data and research to find a solution to this core dilemma. We need evidence-based guidelines to establish a standardized approach to airway management in the prehospital setting. National and local efforts are currently underway.

 

Prehospital airway management review aim

This review wishes to identify and synthesize the evidence available to support the development of evidence-based recommendations and guidelines for prehospital airway management. This systematic review will focus on comparing the benefit and disadvantages of three different airway management approaches: bag valve mask (BVM), SGA, and ETI.

Given the possible variations in the prehospital setting, the review aims to analyze and show the benefits and harms across the following factors: patient health characteristics, the techniques and devices used for each airway management approach; and the characteristics of the EMS personnel.

 

Key questions on prehospital airway management

The Key Questions were posted for public comment on November 22, 2019, through December 20, 2019. Public comments will be considered to inform the review process. However, the comments did not lead to substantive changes in the proposed Key Questions.

The Evidence-based Practice Center (EPC) refined the Key Questions after review of the public comments and input from Key Informants. The Agency for Healthcare Research and Quality further refined and then revised this protocol after receiving input from the Technical Expert Panel (TEP). The protocol will be registered in the international prospective register of systematic reviews (PROSPERO). At the end of the article the link to the full review protocol.

 

EXPLORE

Prehospital Airway Management could change quickly

CPR on cadavers to evaluate supraglottic airway devices on negative intrathoracic pressures

Ultrasound & Clinical Practice – How ultrasound help in case of airway complications

 

READ THE FULL REVIEW PROTOCOL

 

 

SOURCES AND REFERENCES

HHS Gov