Prehospital airway management in Finnish emergency medical service by non-physicians

Prehospital advanced airway management is one of the most demanding procedures in the out-of-hospital scene. Prehospital advanced airway management is indicated based on patient assessment and suspected underlying illness or trauma. Prehospital emergency airway management can be performed using various methods.

Endotracheal intubation (ETI) has been described as the ‘gold standard’ in emergency airway management to ensure sufficient ventilation and oxygenation. In previous years, critical questions have been raised regarding the use of ETI by providers not sufficiently experienced in performing this procedure.

In the Finnish emergency medical service (EMS) system, ETI is rare and therefore often difficult for non-physician care providers. Previous studies have shown SADs to be easy to insert and to provide effective ventilation in manikins, anaesthetized patients and OHCA cases.

The aim of this thesis was to study different airway devices used by non-physicians in prehospital care. In conclusion, the devices studied were used in patients with OHCA or altered consciousness with reasonable success.

The best option for pre-hospital airway management may be an individualized process where the intervention chosen depends on the EMS provider’s skills, the patient and the environmental and organizational circumstances. SADs can also be used by non-experienced providers and as bailout devices by more experienced providers.