Skip Navigation LinksHome > June 2008 - Volume 14 - Issue 3 > Airway techniques and ventilation strategies
Current Opinion in Critical Care:
doi: 10.1097/MCC.0b013e3282f85bc8
Cardiopulmonary resuscitation: Edited by Volker Wenzel

Airway techniques and ventilation strategies

Nolan, Jerry Pa; Soar, Jasmeetb

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Abstract

Purpose of review: To 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 findings: Prehospital 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.

Summary: Supraglottic 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.

© 2008 Lippincott Williams & Wilkins, Inc.

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