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May 8, 2013

Prehospital Airway Management for Out-of-Hospital Cardiac Arrest

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: Emergency Department/Emergency Admission Unit, University Hospital of Leipzig, Leipzig, Germany (Dr Bernhard; michael.bernhard@medizin.uni-leipzig.de); Department of Emergency Medicine, University of Michigan, Ann Arbor (Dr Becker); and Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Cologne, Germany (Dr Böttiger).

JAMA. 2013;309(18):1888. doi:10.1001/jama.2013.3098

To the Editor: Dr Hasegawa and colleagues1 studied different approaches to prehospital airway management (endotracheal intubation, supraglottic airway devices, and bag-valve-mask ventilation) in patients with out-of-hospital cardiac arrest (OHCA) in a Japanese cohort. The conclusion of the authors is in contrast to other evidence.

First, several studies have shown poor success rates of about 80% for prehospital endotracheal intubation performed by paramedics,2 but Hasegawa et al1 did not report the success rates of either endotracheal intubation or supraglottic airway devices in their cohort, or the incidence of undetected esophageal intubation or supraglottic airway device displacement.