Advanced Airway Management Techniques for Paramedics: (Review Artical)
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- Category: Vol. 86, December 2018
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Advanced Airway Management Techniques for Paramedics: (Review Artical)
Abstract
Background: The pre-hospital emergency anesthesia (PHEA) and advanced airway management is still a subject of debate, with a divergence of opinions on the potential advan-tages or disadvantages of sophisticated interventions. It is evi-dent that there exists a small yet distinguishable set of patients who have specific reasons for needing intubation, where basic airway maneuvers are insufficient to maintain proper oxygen levels, and more complex airway interventions are necessary at an early stage. Aim of Study: This article aims to provide a comprehensive analysis of the arguments supporting and opposing the use of advanced pre-hospital airway care and pre-hospital emergency anesthesia (PHEA), and to address the contentious issues sur-rounding this subject. Methods: The review examines the necessity of advanced airway procedures performed in the pre-hospital situation by evaluating the number of patients who present to the emergency department (ED) with indications for immediate tracheal intu-
bation. It also discusses the effective methods for managing airways before reaching the hospital, including a comparison of the effectiveness of bag-valve mask (BVM) ventilation with advanced airway management techniques. Results: Studies have shown that approximately 10% of trauma admissions in the United States necessitate advanced airway intervention within the first 5 hours of arriving at the hospital, with more than half of these patients exhibiting urgent indications for intubation. The data from various studies on the effectiveness of advanced airway techniques compared to basic approaches is mixed, with some studies finding no advantage and others indicating benefits for severely-injured patients or those with traumatic brain injury. Conclusion: The review highlights the ongoing debate and the need for further research to determine the optimal approach-es for pre-hospital advanced airway management and PHEA, taking into account the various factors and patient populations involved