Evidence-Based Guideline for Prehospital Airway Management
Jeffrey L. Jarvis, Ashish R. Panchal, John W. Lyng, Nichole Bosson, J. Joelle Donofrio-Ödmann, Darren Braude, Lorin R. Browne, Michael Arinder, Scott Bolleter, Toni Gross, Michael Levy, George Lindbeck, Lauren Maloney, Connie J. Mattera, C. Jason Wang, Remle P. Crowe, Christopher B. Gage, Eddy Lang, J. Matthew Sholl
Abstract
Airway management is a cornerstone of emergency medical care. This project aimed to create evidence-based guidelines based on the systematic review recently conducted by the Agency for Healthcare Research and Quality (AHRQ). A technical expert panel was assembled to review the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The panel made specific recommendations on the different PICO (population, intervention, comparison, outcome) questions reviewed in the AHRQ review and created good practice statements that summarize and operationalize these recommendations. The recommendations address the use of ventilation with bag-valve mask ventilation alone vs. supraglottic airways vs. endotracheal intubation for adults and children with cardiac arrest, medical emergencies, and trauma. Additional recommendations address the use of video laryngoscopy and drug-assisted airway management. These recommendations, and the associated good practice statements, offer EMS agencies and clinicians an opportunity to review the available evidence and incorporate it into their airway management strategies.