Airway in a Cardiac Arrest

In this lecture from the ResusX: ROSC Conference (see link below for more lectures), Dr. Tarlan Hedayati delves into the contentious topic of airway management during cardiac arrest. Examining key studies like the Airways-2 and PART trials, Dr. Hedayati compares the efficacy of Supraglottic Airways versus Endotracheal Intubation, shedding light on success rates, neurologic outcomes, and paramedic preferences.
Moreover, a comprehensive meta-analysis reinforces the superiority of Supraglottic Airways in cardiac resuscitation scenarios. With a focus on prioritizing CPR and swift airway control, Dr. Hedayati advocates for Supraglottic Airways as the preferred modality, highlighting the practical challenges and advantages over Bag-Valve-Mask and Endotracheal Intubation.
00:00 Introduction to Airway Management in Cardiac Arrest
00:22 The Evolution of ACLS Guidelines and Airway Prioritization
01:16 Supraglottic Airway vs Endotracheal Intubation: The Airways-2 Trial
04:02 Laryngeal Tube vs Endotracheal Intubation: The PART Trial
05:48 Promotion of the ROSC Conference
06:09 Meta-analysis of Endotracheal Intubation vs Supraglottic Airway
06:59 Bag-Valve-Mask vs Endotracheal Intubation
08:50 Advanced Airway Management vs Bag-Valve-Mask: A Korean Study
10:04 Final Recommendations and Conclusion
To watch more videos from the ResusX: ROSC conference, check out www.resusx.com/offers/d2zx2ZiP
Hashtags:
#CriticalCare, #EmergencyMedicine, #CardiacArrest, #AirwayManagement, #Resuscitation, #ACLSGuidelines, #EndotrachealIntubation, #SupraglotticAirway, #BagValveMask, #AdvancedAirwayManagement, #MetaAnalysis, #ROSCConference, #PrehospitalCare, #Paramedics, #NeurologicOutcome

[@jimmyapple]

The PART trial (Similar to the ROC PRIMED trial, also found survival to be higher in patient's with only BVM ventilation. It's also worth mentioning regarding the AIRWAYS-2 trial that in the UK ground crews do not intubate in cardiac arrest. They rarely intubate at all. That is almost entirely within the purview of HEMS.

[@davidbuckner882]

Are there any published studies for ER/ICU on this? (Or at least metanalysis favoring IP) Having worked prehospital for many years before trading roadsides and the floors of Chinese restaurants for climate control and ergonomically positioned patients extrapolating prehospital data to me seems like adding an extra variable. (Especially considering the 18% part) I think there is a valid point to be made that the paramedic who does one intubation every few months (or even a hospitalist responding to a code who does not routinely resus) and only has DL should strongly consider SGA first as non-inferior. But when it is an inhospital arrest with adequate EM/CC staff, VL already at beside, I don’t think this answers the question of if a provider who can intubate a pt without requiring stopping CPR should choose initial resus with SGA vs going ahead with intubation.

[@joshmcgoo]

At stony we tend to do LMA until rosc unless there’s anatomic concerns

[@CriticalCareNow]

Love this!

[@soronazarova3992]

Could you please link the sources you use in the presentation?

[@poliklolik]

Supraglottic airways are not equal!

[@CriticalCareNow]

Totally true!