• Best Pract Res Clin Anaesthesiol · May 2021

    Review

    Optimizing airway management and ventilation during prehospital advanced life support in out-of-hospital cardiac arrest: A narrative review.

    • Hans van Schuppen, René Boomars, Fabian O Kooij, Paul den Tex, Rudolph W Koster, and Markus W Hollmann.
    • Amsterdam UMC, University of Amsterdam, Department of Anesthesiology, Meibergdreef 9, Amsterdam, the Netherlands. Electronic address: j.l.vanschuppen@amsterdamumc.nl.
    • Best Pract Res Clin Anaesthesiol. 2021 May 1; 35 (1): 67-82.

    AbstractAirway management and ventilation are essential components of cardiopulmonary resuscitation to achieve oxygen delivery in order to prevent hypoxic injury and increase the chance of survival. Weighing the relative benefits and downsides, the best approach is a staged strategy; start with a focus on high-quality chest compressions and defibrillation, then optimize mask ventilation while preparing for advanced airway management with a supraglottic airway device. Endotracheal intubation can still be indicated, but has the largest downsides of all advanced airway techniques. Whichever stage of airway management, ventilation and chest compression quality should be closely monitored. Capnography has many advantages and should be used routinely. Optimizing ventilation strategies, harmonizing ventilation with mechanical chest compression devices, and implementation in complex and stressful environments are challenges we need to face through collaborative innovation, research, and implementation.Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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