To the Editor: We are concerned that the study by Dr Hasegawa and colleagues1 on prehospital advanced airway management in patients with OHCA has not accounted for one important selection bias or confounding by indication. There are significant differences in the practice of paramedics in Japan compared with the United States, including the indication for advanced airway devices.
Norii T, Hatanaka T. Prehospital Airway Management for Out-of-Hospital Cardiac Arrest. JAMA. 2013;309(18):1888–1890. doi:10.1001/jama.2013.3104
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