Endotracheal Intubation vs. Supraglottic Airway Placement for Out-of-Hospital Cardiac Arrest

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If you want to get a group of prehospital providers riled up, simply ask them how the airway should be managed during out-of-hospital cardiac arrest.  

"Supraglottic airways are easier!"  

"No, you gotta stay with endotracheal intubation!"  

"Forget advanced airways, a bag-valve mask is all you need!"  

"Only apneic oxygenation!"  

Don't believe me?  Here's an example...

This same debate raged in Cincinnati a few months back.  Our EMS protocol committee had advised two attempts at endotracheal intubation and then try a supraglottic airway.  However, some were arguing that we should only use supraglottic airways.  Studies have demonstrated supraglottics are quicker and easier to insert, resulting in less impact to chest compression continuity.  But are they better for patient outcomes?

We decided to address that question directly.  We collected the world's literature on endotracheal intubation vs. supraglottic airways for out-of-hospital cardiac arrest and conducted a meta-analysis.  Want to know what we found?  Check out this five minute video:

For the record, we have no conflicts of interest to disclose.  Also, although the video is not peer-reviewed, the manuscript is, which you can read here:

http://linkinghub.elsevier.com/retrieve/doi/10.1016/j.resuscitation.2015.05.007?goto=sd