• Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome: The AIRWAYS-2 Randomized Clinical Trial

      Benger, Jonathan; Kirby, Kim; Black, Sarah; Brett, Stephen; Clout, Madeleine; Lazaroo, Michelle; Nolan, Jerry; Reeves, Barnaby; Robinson, Maria; Scott, Lauren; et al. (2018-08-28)
    • An exploration of the experiences of paramedics taking part in a large randomised trial of airway management, and the impact on their views and practice

      Kirby, Kim; Brandling, Janet; Robinson, Maria; Voss, Sarah; Benger, Jonathan (2019-09-24)
      Background The participation of over 1500 study paramedics in AIRWAYS-2 provides a unique opportunity for an in depth exploration of how the views and practice of study paramedics, in advanced airway management, may have developed as a result of their participation in AIRWAYS-2, and how their experiences can inform future trials in out-of-hospital cardiac arrest (OHCA). Future prehospital guidelines and practice will not only be shaped by the results of large trials such as AIRWAYS-2, but also by the views and attitudes of UK paramedics towards OHCA, airway management and research. This study allows an opportunity to add depth and understanding to the results of AIRWAYS-2. Study aims To explore paramedics’ experiences of participating in a large cluster randomized trial of airway management during OHCA, specifically: The challenges of enrolling patients who are critically unwell and unable to consent; Barriers and facilitators to successful research in OHCA patients; The impact on paramedics’ clinical practice and airway management during and after the trial; The role of advanced airway management during OHCA. Methods Content analysis of an online survey of 1500 study paramedics to assess their experiences of participating in the trial and to establish any changes in their views and practice. Thematic analysis of telephone interviews with study paramedic to explore the findings of the online questionnaire. Exploring any changes in views and practice around advanced airway management as a result of participating in the trial; assessing experiences of trial training and enrolling critically unwell patients without consent, and exploring the barriers and facilitators for trial participation and the views of paramedics on the future role of advanced airway management during OHCA. Results and conclusions The study is in the analysis phase and is due to complete and report by the 31st January 2019. https://emj.bmj.com/content/36/10/e12.1. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emermed-2019-999abs.27
    • Randomised comparison of the effectiveness of the laryngeal mask airway supreme, i-gel and current practice in the initial airway management of prehospital cardiac arrest (REVIVE-Airways): a feasibility study research protocol

      Benger, Jonathan; Voss, Sarah; Coates, David; Greenwood, Rosemary; Nolan, Jerry; Rawstorne, Steven; Rhys, Megan; Thomas, Matthew (2013-02-13)
      Effective cardiopulmonary resuscitation with appropriate airway management improves outcomes following out-of-hospital cardiac arrest (OHCA). Historically, tracheal intubation has been accepted as the optimal form of OHCA airway management in the UK. The Joint Royal Colleges Ambulance Liaison Committee recently concluded that newer supraglottic airway devices (SADs) are safe and effective devices for hospital procedures and that their use in OHCA should be investigated. This study will address an identified gap in current knowledge by assessing whether it is feasible to use a cluster randomised design to compare SADs with current practice, and also to each other, during OHCA. https://bmjopen.bmj.com/content/3/2/e002467 This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/bmjopen-2012-002467
    • A survey of paramedic advanced airway practice in the UK

      Younger, Paul; Pilbery, Richard; Lethbridge, Kris (2016-12)
      Abstract published with permission. Introduction ‐ Although there are published studies examining UK paramedic airway management in the out-of-hospital setting, there has been no sizeable survey of practicing UK paramedics that examines their advanced airway management practice, training and confidence. Therefore, the Airway Management Group of the College of Paramedics commissioned a survey to gain an up to date snapshot of advanced airway management practice across the UK among paramedics. Methods ‐ An online questionnaire was created, and a convenience sample of Health and Care Professions Council (HCPC) registered paramedics was invited to participate in the survey. Invitations were made using the College of Paramedics e-mail mailing list, the College website, as well as social media services such as Twitter and Facebook. The survey ran online for 28 days from 21 October to 18 November 2014 to allow as many paramedics to participate as possible. The survey questions considered a range of topics including which supraglottic airway devices are most commonly available in practice and whether or not tracheal intubation also formed a part of individual skillsets. In relation to intubation, respondents were asked a range of questions including which education programmes had been used for original skill acquisition, how skills were maintained, what techniques and equipment were available for intubation attempts, individual practitioner confidence in intubation and how intubation attempts were documented. Results ‐ A total of 1658 responses to the survey were received. Following data cleansing, 152 respondents were removed from the survey, leaving a total of 1506. This represented 7.3% of paramedics registered with the HCPC (20,565) at the time the survey was conducted. The majority of respondents were employed within NHS ambulance services. Summary ‐ This is the largest survey of UK paramedics conducted to date, in relation to advanced airway management. It provides an overview of advanced airway management, with a particular focus on intubation, being conducted by UK paramedics.