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Attitudes of firefighters towards the use of supraglottic airways devices

Published:January 16, 2019DOI:https://doi.org/10.1016/j.ajem.2019.01.028
      In the article “Advanced airway management in out of hospital cardiac arrest: A systematic review and meta-analysis” by White et al. published in The American Journal of Emergency Medicine, the authors indicate that the overall heterogeneous benefit in survival with ETT was not replicated in the low risk randomized controlled trials, with no significant difference in survival or neurological outcome [
      • White L.
      • Melhuish T.
      • Holyoak R.
      • et al.
      Advanced airway management in out of hospital cardiac arrest: a systematic review and meta-analysis.
      ]. It is worth noting that endotracheal intubation is a highly specialized procedure, requiring from the person performing it a lot of knowledge and skills in its use. As Buis et al. indicate, the learning curve for direct laryngoscopy is about 50 intubations [
      • Buis M.L.
      • Maissan I.M.
      • Hoeks S.E.
      • et al.
      Defining the learning curve for endotracheal intubation using direct laryngoscopy: a systematic review.
      ]. In the case of videolaryngoscopy it is much lower [
      • Gawel W.
      • Kaminska H.
      • Wieczorek W.
      UESope as a method of endotracheal intubation of trauma patient.
      ,
      • Ladny J.R.
      • Sierzantowicz R.
      • Kedziora J.
      • et al.
      Comparison of direct and optical laryngoscopy during simulated cardiopulmonary resuscitation.
      ,
      • Madziala M.
      The ETView tracheoscopic ventilation tube for trauma patient intubation.
      ]. After all, because of the cost of videolaryngoscopes, they are relatively rarely used in pre-hospital settings. An alternative to them can be supraglottic airway devices, which in present times are used not only in pre-hospital settings [
      • Frass M.
      • Robak O.
      • Smereka J.
      • et al.
      Securing the airway patency by firefighters with the use of CombiTube. A pilot data.
      ,
      • Ladny J.R.
      • Bielski K.
      • Szarpak L.
      • et al.
      Are nurses able to perform blind intubation? Randomized comparison of I-gel and laryngeal mask airway.
      ], but also under operating theatre conditions [
      • Robak O.
      • Vaida S.
      • Somri M.
      • et al.
      Inter-center comparison of EasyTube and endotracheal tube during general anesthesia in minor elective surgery.
      ].
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