Introduction
Approximately 360 000 adults suffer an emergency medical service (treated out of hospital cardiac arrest in the
United States each year. Cardiac arrest continues to be a devastating condition for most individuals with a current overall survival rate of around 10%.
Outcomes have improved since the introduction of the cardiac arrest chain of survival in the early 1990 s however,
there are still many areas of resuscitation science to be explored, which could potentially improve patient outcomes.One of the most important links in the chain is early high quality cardiopulmonary resuscitation (with an emphasis on chest compressions. However, guidelines provide rescuers with minimal direction on optimal ventilation management during resuscitation.- Ventilation may play a crucial role in cardiac arrest resuscitation by allowing for adequate oxygen administration and meaningful carbon dioxide elimination, thereby improving cellular metabolism.
- Modifiable factors affecting out of hospital ventilation include rate, tidal volume, ventilation delivery time, airway pressure, and timing with chest compressions.
- The goals of this narrative review are to evaluate the available evidence regarding the role of ventilation in out of hospital cardiac arrest resuscitation and to provide recommendations for future directions.
Airway management is one of the most essential interventions in the prehospital care of the critically ill or injured.
Basic airway interventions Basic airway interventions include measures to provide supplemental oxygen and/or ventilation without the use of an advanced airway device
These techniques are practiced by all prehospital providers, including first responders, EMTs, paramedics, and EMS physicians.
Many scientific efforts have highlighted the difficulty of endotracheal intubation ( in the prehospital setting, the adverse events associated with the procedure, and the challenges in attaining and maintaining clinical proficiency
Other studies highlight the uncertain connections with improved patient outcomes.
These observations underscore that airway management is not simply a discrete procedure but a comprehensive strategy of care that requires close, system-level medical oversight.
The most successful prehospital airway management programs incorporate multiple elements including training, skills verification, equipment selection, decision support, continuing education, and total quality management.