Does paramedic intubation improve patient outcome?

Since the position statement on pre-hospital airway management by the Joint Royal Colleges Ambulance Liaison Committee in 2008, the debate has shown no sign of relenting. The prevailing argument for those who are pro-paramedic endotracheal intubation has long been that the original position statement was based on low quality international research which is not entirely transferable to UK practice. With this in mind, there have been increased efforts in recent years to produce data which can provide an accurate and reliable answer to the question of whether paramedic intubation is beneficial to patient care.

This meta-analysis investigated the outcomes of adult patients who had suffered a non traumatic out-of-hospital cardiac arrest and as part of their treatment had either an endotracheal tube inserted or a supraglottic airway device placed by a paramedic.

The primary search identified 3 454 papers and ultimately 10 observational studies met the inclusion criteria for this meta-analysis representing 34 533 individuals who received endotracheal intubation (ETI) and 41 116 who received a supraglottic airway device. All presenting cardiac arrest rhythms were included.