Pre-hospital airway management preferences of paramedics

Aim: The success of paramedics in the pre-hospital airway management in traumatic and non-traumatic critically ill patients, especially in cardiac arrest, is very important in terms of mortality and morbidity. Materials and Methods: Patients who were admitted to the Emergency Department by pre-hospital emergency ambulance service were included in the study. The standard data registration form was created for the study. Demographic data, pre-hospital and in-hospital vital signs, GCS scores, cardiac rhythms, applied airway method, transport time and 48-hour mortality rates were recorded in the study form. Results: While the initial approach to airway management was a bag-valve mask in 80 patients (82%), advanced airway management was performed in 18 (18%) patients. The mean time period for the ambulance arriving at the patient was 6.52 +/- 3.06 min and the mean time period of transport to the hospital was 11.42 +/- 9.53 min in all patients. Although there was no difference between patients managed with BVM and patients managed with advanced airway interventions in terms of a time period needed to access patient (p=0.957), there were significant differences in terms of a time period needed to access emergency service (p=0.001) and total time period (p=0.001) Among patients with CPA, there was a significant difference between patients managed with and without advanced airway interventions in terms of 48-hour mortality (p=0.035). Discussion: Although the pre-hospital airway management still remains its mystery, we think that providing ventilation with BVM without losing time and transportation to the hospital would be more appropriate for patients in short distances and for patients with less risk of aspiration in terms of mortality and transportation time.