In Reply As Dr Huang and colleagues note, there were small differences in patient and response characteristics between the initial LT and initial ETI groups. However, in predefined subgroup analyses, including cardiac rhythm and response times, these variations were not associated with the observed treatment effects (eFigure 5 in Supplement 2).1 Among the 3004 patients, 116 received LT placement by basic life support personnel; most of the remaining airways were managed by advanced life support paramedics (eTable 3 in Supplement 2). We could not further characterize rescuer airway training and experience. While rescuers reported slightly higher rates of inadequate ventilation with LT than ETI (1.8% vs 0.6%), in cardiac arrest, it is difficult to ascertain ventilatory quality with either technique. Huang and colleagues suggest that paramedics may have altered airway management strategies based on physical findings, but in the challenging setting of cardiac arrest, only limited airway assessment is possible.
Wang HE, Schmicker RH, Daya MR. Laryngeal Tube Insertion vs Endotracheal Intubation for Out-of-Hospital Cardiac Arrest—Reply. JAMA. 2019;321(1):105–106. doi:10.1001/jama.2018.18115
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: