Survival of Casualties Undergoing Prehospital Supraglottic Airway Placement Versus Cricothyrotomy

Schauer, Steven G; Naylor, Jason F; Chow, Annie L; Maddry, Joseph K.; Cunningham, Cord W.; Blackburn, Megan B; Nawn, Corinne D.; April, Michael D.

doi:10.55460/d4c5-pvhk

Cited by 10 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A previously published study demonstrated that outcomes are similar with cricothyrotomy versus supraglottic airway (SGA) device placement in the combat setting suggesting that SGAs may supplant the need for cricothyrotomy training and/or application 7 . Another study by our team found that we are likely to not detect any differences between devices due to: (1) limitations in training prior to enrollment (e.g., we are finding inadequate preenrollment training) therefore, (2) we are unlikely to identify the ideal device using a purely quantitative approach since all devices will likely perform in a similar fashion in the hands of untrained or limited trained medics.…”

mentioning

confidence: 99%

A mixed methods end-user assessment to determine the ideal supraglottic airway device for inclusion into the medic's aid bag

Schauer

Tapia

Hudson

et al. 2022

J Trauma Acute Care Surg

View full text Add to dashboard Cite

BACKGROUND:Many advancements in supraglottic airway technology have occurred since the start of the Global War on Terrorism. While the Tactical Combat Casualty Care guidelines previously recommend the i-gel device, this is based on little data and minimal enduser input. OBJECTIVE:We sought to use a mixed methods approach to investigate the properties of an ideal device for inclusion into the medic's aid bag. METHODS:We performed prospective, serial qualitative studies to uncover and articulate themes relative to airway device usability with 68Wcombat medics. 68W are trained roughly to the level of a civilian advanced emergency medical technician with a heavier focus on trauma care. Physicians with airway expertise demonstrated the use of each device and provided formal training on all the presented devices. We then administered performed focus groups to solicit end-user feedback along with survey data. RESULTS:We enrolled 250 medics during the study. The preponderance of medics were of the rank E4 (28%) and E5 (44%). Only 35% reported ever placing a supraglottic airway in a real human. When reporting on usability, the i-gel had the highest median score, ease of manipulation, grip comfort and ease of insertion while also scoring the best in regard to requiring minimal training. The other compared devices had no clear highest score. Qualitative data saturated around a strong preference for the BaskaMask and/or the i-gel airway device, with the least favorite being the AirQ and the LMA Fastrach airway devises. There was a strong qualitative alignment in how both the BaskaMask and i-gel provided ease of use and simplicity of training. CONCLUSION:There were strong qualitative preferences for two specific airway devices: Baska Mask and i-gel. However, many medics commented on their previous experience with the i-gel compared with the other devices, which may have biased them toward the i-gel. The overall data suggest that medics would prefer a device engineered with features from several devices.

show abstract

mentioning

confidence: 99%

A mixed methods end-user assessment to determine the ideal supraglottic airway device for inclusion into the medic's aid bag

Schauer

Tapia

Hudson

et al. 2022

J Trauma Acute Care Surg

View full text Add to dashboard Cite

show abstract

“…4,5 Another focus of these studies is the impact of medical interventions on patient survival. 6,7 Equally important is proactive identification of patients at increased risk of deterioration. Vital signs offer a readily obtainable physiologic tool for early prognostication.…”

Section: Introductionmentioning

confidence: 99%

Early Vital Sign Thresholds Associated with 24-Hour Mortality among Trauma Patients: A Trauma Quality Improvement Program (TQIP) Study

April,

Fisher,

Rizzo

et al. 2024

Prehosp. Disaster med.

View full text Add to dashboard Cite

Background: Identifying patients at imminent risk of death is critical in the management of trauma patients. This study measures the vital sign thresholds associated with death among trauma patients. Methods: This study included data from patients ≥15 years of age in the American College of Surgeons Trauma Quality Improvement Program (TQIP) database. Patients with vital signs of zero were excluded. Documented prehospital and emergency department (ED) vital signs included systolic pressure, heart rate, respiratory rate, and calculated shock index (SI). The area under the receiver operator curves (AUROC) was used to assess the accuracy of these variables for predicting 24-hour survival. Optimal thresholds to predict mortality were identified using Youden’s Index, 90% specificity, and 90% sensitivity. Additional analyses examined patients 70+ years of age. Results: There were 1,439,221 subjects in the 2019-2020 datasets that met inclusion for this analysis with <0.1% (10,270) who died within 24 hours. The optimal threshold for prehospital systolic pressure was 110, pulse rate was 110, SI was 0.9, and respiratory rate was 15. The optimal threshold for the ED systolic was 112, pulse rate was 107, SI was 0.9, and respiratory rate was 21. Among the elderly sub-analysis, the optimal threshold for prehospital systolic was 116, pulse rate was 100, SI was 0.8, and respiratory rate was 21. The optimal threshold for ED systolic was 121, pulse rate was 95, SI was 0.8, and respiratory rate was 0.8. Conclusions: Systolic blood pressure (SBP) and SI offered the best predictor of mortality among trauma patients. The SBP values predictive of mortality were significantly higher than the traditional 90mmHg threshold. This dataset highlights the need for better methods to guide resuscitation as initial vital signs have limited accuracy in predicting subsequent mortality.

show abstract

“…Supplementary Table S1 details the findings of each included study; the quality of evidence findings are available in Supplementary Table S2 . 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 56 , 57 , 58 , 59 , 60 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 Thirty-three studies were low quality and 36 were very low quality. …”

Section: Resultsmentioning

confidence: 99%

“…complication rates could not be separated from failure rates). 56 , 58 , 60 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 If these studies reported FONA success rates, it may have altered the findings of this systematic review, particularly within certain population groups. As an example, Diggs and colleagues 63 would potentially add more than 1000 patients to the Emergency Medical Services group.…”

Section: Discussionmentioning

confidence: 99%

Success rate of prehospital emergency front-of-neck access (FONA): a systematic review and meta-analysis

Morton

Avery

Kua

et al. 2023

British Journal of Anaesthesia

View full text Add to dashboard Cite

Survival of Casualties Undergoing Prehospital Supraglottic Airway Placement Versus Cricothyrotomy

Cited by 10 publications

References 0 publications

A mixed methods end-user assessment to determine the ideal supraglottic airway device for inclusion into the medic's aid bag

A mixed methods end-user assessment to determine the ideal supraglottic airway device for inclusion into the medic's aid bag

Early Vital Sign Thresholds Associated with 24-Hour Mortality among Trauma Patients: A Trauma Quality Improvement Program (TQIP) Study

Success rate of prehospital emergency front-of-neck access (FONA): a systematic review and meta-analysis

Contact Info

Product

Resources

About