By Sarah Roebuck
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COLUMBUS, Ohio 鈥� A new study from shows that paramedics are changing how they help patients breathe before they arrive at the hospital.
The study, which was published in , examined how EMS throughout the country manages their patients鈥� airways.
鈥淧aramedics and emergency medical technicians are usually the first to provide lifesaving medical care for critically ill patients,鈥� said , lead author and clinical professor of emergency medicine. 鈥淚t鈥檚 important to understand EMS airway management practices so hospitals know the best method to transition patients from the ambulance and manage any potential complications.鈥�
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The study examined EMS data from the , one of the largest in the U.S., focusing on patient encounters from 2011 to 2022 where advanced airway management, like endotracheal intubation (ETI) and supraglottic airways (SGA), was attempted.
Between 2011 and 2022, there were 47.5 million EMS calls for medical emergencies. Among those, 444,041 involved attempts at advanced airway management, including 343,312 for cardiac arrests, 79,358 for non-cardiac emergencies and 21,371 for trauma cases, according to researchers.
For over 40 years, ETI 鈥� a challenging procedure where a tube is placed into the lungs through the mouth 鈥� has been the primary method to help patients breathe, researchers stated. However, in the last decade, there鈥檚 been a significant shift toward using supraglottic airways SGAs, devices placed above the vocal cords, especially for cardiac arrest patients. Today, most cardiac arrests are managed with SGA instead of ETI.
鈥淪GA is considered to be a simpler, faster airway management technique,鈥� Wang said. 鈥淵ou can achieve similar ventilation results with less training.鈥�
During the study period, ETI attempts for cardiac arrest patients decreased from 87.3% to 55.1%, while SGA attempts increased from 25.1% to 61%. From 2020 to 2022, SGA was used more often than ETI for cardiac arrests. Similar trends were observed in non-cardiac and trauma patients, though less pronounced.
鈥淭his is the first formal study confirming that paramedic practice has changed to favor SGA over ETI,鈥� Wang said. 鈥淚t is important to understand national EMS clinical practices to better allocate emergency resources and improve training.鈥�
Want is currently leading ongoing research to determine the best method of advanced airway management in children.
