• Curr Opin Crit Care · Jun 2008

    Review

    Airway techniques and ventilation strategies.

    • Jerry P Nolan and Jasmeet Soar.
    • Royal United Hospital, Bath, UK. Jerry.nolan@ruh.nhs.uk
    • Curr Opin Crit Care. 2008 Jun 1;14(3):279-86.

    Purpose Of ReviewTo discuss the advantages and disadvantages of various methods of airway management during cardiopulmonary resuscitation. The role of ventilation during out-of-hospital cardiopulmonary resuscitation is also discussed.Recent FindingsPrehospital studies fail to show any benefit from tracheal intubation during cardiopulmonary resuscitation and many show harm. Use of a supraglottic airway device may be preferable for rescuers who are not highly skilled in tracheal intubation. Bystander cardiopulmonary resuscitation increases survival rates from out-of-hospital cardiac arrest. Following a witnessed, sudden collapse, survival rates achieved when bystanders deliver compression-only cardiopulmonary resuscitation are at least the same as those achieved with cardiopulmonary resuscitation that includes mouth-to-mouth ventilation (rescue breathing). Some investigators have reported higher survival rates following the introduction of cardiocerebral resuscitation--a strategy that de-emphasizes ventilation during initial resuscitation by emergency medical services personnel.SummarySupraglottic airway devices are a logical alternative to tracheal intubation when cardiopulmonary resuscitation is undertaken by individuals who are not highly skilled and experienced intubators. By teaching laypeople compression-only cardiopulmonary resuscitation, it is hypothesized that rates of bystander cardiopulmonary resuscitation, and therefore survival after out-of-hospital cardiac arrest, will increase.

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