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The impact of supraglottic airway use on out-of-hospital orotracheal intubation

Hilton, Michael T. (2014) The impact of supraglottic airway use on out-of-hospital orotracheal intubation. Master Essay, University of Pittsburgh.

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Abstract

Objective: Orotracheal intubation is a mainstay of prehospital airway management and is a critical life-saving skill of paramedics. The impact of a new generation of supraglottic airway on orotracheal intubation success rate is unknown. This is an issue of public health importance because if orotracheal intubation success has decreased, this places the public at risk of adverse events. A lower success rate would require additional health care resources directed to improving the training or skills maintenance of paramedics. This would necessitate a multidisciplinary approach spanning the domains of health policy, risk communication, intervention planning and evaluation and biostatistics. I aim to determine whether orotracheal intubation success rates have changed since the introduction of a new generation of supraglottic airway, the King LTD, in an EMS system. Methods: This was a retrospective before and after observational study of 36 EMS services in a 10-county region. Cases between Jan. 1, 2005 and Dec. 31, 2012 were included if there was an advanced airway procedure performed. The proportion of cases with first pass success was compared before and after the King LTD was introduced in 2007. A secondary outcome was the proportion of cases ultimately managed with orotracheal intubation. Results: The proportion of cases with first pass success did not change before and after 2007. The proportion of cases ultimately managed with orotracheal intubation decreased significantly. Conclusion: Fewer patients ultimately received orotracheal intubation after the introduction of the King LTD, although orotracheal intubation success rates did not change. Supraglottic airways may primarily provide an alternative to further orotracheal intubation attempts in the prehospital setting. Continuing public health surveillance of the changing landscape of prehospital airway management will be important as new airway devices are introduced.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Hilton, Michael T.mth36@pitt.eduMTH36
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairFeingold, Eleanorfeingold@pitt.eduFEINGOLDUNSPECIFIED
Committee MemberYabes, Jonathanjgyabes@gmail.comUNSPECIFIEDUNSPECIFIED
Date: 2014
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Publisher: University of Pittsburgh
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Multidisciplinary MPH
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 11 Aug 2015 22:03
Last Modified: 02 Jul 2019 14:02
URI: http://d-scholarship.pitt.edu/id/eprint/21035

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