References

Benger JR, Voss S, Coates D Randomised comparison of the effectiveness of the laryngeal mask airway supreme, i-gel and current practice in the initial airway management of prehospital cardiac arrest (REVIVE-Airways): A feasibility study research protocol. BMJ Open. 2013; 3:(2) https://doi.org/10.1136/bmjopen-2012-002467

Berdowski J, Berg RA, Tijssen JG, Koster RW. Global incidence of out-of-hospital cardiac arrest and survival rates; systematic review of 67 prospective studies. Resuscitation. 2010; 81:(11)1479-1487 https://doi.org/https//.org/10.1016/j.resuscitation.2010.08.006

Burges Watson DL, Sanoff R Evidence from the scene: paramedic perspectives on involvement in out-of-hospital research. Ann Emerg Med.. 2012; 60:(5)641-650 https://doi.org/https//.org/10.1016/j.annemergmed.2011.12.002

Burns N, Grove S. The Practice of Nursing Research, appraisal, synthesis and generation of evidence, 6th edn. St Louis, MO: Saunders; 2009

Deakin CD, Clarke T, Nolan J A critical reassessment of ambulance service airway management in prehospital care: Joint Royal Colleges Ambulance Liaison Committee Airway Working Group, June 2008. Emerg Med J.. 2010; 27:(3)226-233 https://doi.org/https//.org/10.1136/emj.2009.082115

Lerner EB, Weik T, Edgerton EA. Research in prehospital care: overcoming the barriers to success. Prehosp Emerg Care. 2016; 20:(4)448-453 https://doi.org/https//.org/10.3109/10903127.2014.980480

Research on the rise in ambulance services. 2017. https//tinyurl.com/y8b9aj28 (accessed 23 April 2018)

NHS England. NHS England Ambulance Quality Indicators: Clincal Outcomes. 2017. https//tinyurl.com/yay2eccs (accessed 26 April 2018)

Soar J, Nolan JP. Airway management in cardiopulmonary resuscitation. Curr Opin Crit Care. 2013; 19:(3)181-187 https://doi.org/https//.org/10.1097/MCC.0b013e328360ac5e

Siriwardena AN, Donohoe R, Stephenson J, Phillips P. Supporting research and development in ambulance services: research for better health care in prehospital settings. Emerg Med J.. 2010; 27:(4)324-326 https://doi.org/https//.org/10.1136/emj.2009.072363

Taylor J, Black S, Brett SJ. Design and implementation of the AIRWAYS-2 trial: A multi-centre cluster randomised controlled trial of the clinical and cost effectiveness of the i-gel supraglottic airway device versus tracheal intubation in the initial airway management of out of hospital cardiac arrest. Resuscitation. 2016; 109:25-32 https://doi.org/https//.org/10.1016/j.resuscitation.2016.09.016

Turner J, Nicholl J, Webber L, Cox H, Dixon S, Yates D. A randomised controlled trial of prehospital intravenous fluid replacement therapy in serious trauma. Health Technol Assess.. 2000; 4:(31)1-57

Wang HE, Yealy DM. Managing the airway during cardiac arrest. JAMA. 2013; 309:(3)285-286 https://doi.org/https//.org/10.1001/jama.2012.216998

Woollard M, Furber R. The College of Paramedics (British Paramedic Association) position paper regarding the Joint Royal Colleges Ambulance Liaison Committee recommendations on paramedic intubation. Emerg Med J.. 2010; 27:(3)167-170 https://doi.org/https//.org/10.1136/emj.2009.088443

paramedic
patient care
OHCA
pre-hospital
respiratory

Paramedic views on clinical research in cardiac arrest

02 May 2018
Features
02 May 2018
Volume 10 · Issue 5

Abstract

Background:

The success of pre-hospital research relies on positive engagement from paramedics. Without adequate participation and protocol compliance, trials will not succeed.

Aims:

The aims of the current research were to seek feedback from paramedics about trial participation and determine their views and preferences regarding a large-scale research study in future.

Methods:

Paramedics participating in REVIVE-Airways, a trial of airway management in out-of-hospital cardiac arrest, were sent a feedback questionnaire according to their study allocation.

Findings:

Of the total respondents, 99% were willing to participate in a further large-scale trial. Participants offered recommendations for future pre-hospital trials.

Conclusion:

There was strong support for further clinical trials of alternative airway management strategies during out-of-hospital cardiac arrest. Paramedics welcome opportunities to participate in research and receive feedback about trial progress and patient outcomes.

Despite continuing research to improve outcomes from out-of-hospital cardiac arrest (OHCA), survival rates remain poor (Berdowski et al, 2010; NHS England, 2017). Cardiopulmonary resuscitation (CPR) combined with effective airway management maximises the chances of survival (Wang and Yealy, 2013). However, the best method of initial airway management in OHCA is unknown (Woollard and Furber, 2010).

Recommendations from the Airway Working Group of the Joint Royal Colleges Ambulance Liaison Committee (JRCALC) conclude that the previously accepted standard of tracheal intubation may not be the optimal approach and newer supraglottic airway devices (SADs) should be investigated (Deakin et al, 2012).

Evidence regarding the best initial approach to airway management in OHCA has been observational to date, leading to calls for a large-scale, prospective, randomised trial (Soar and Nolan, 2013). REVIVE-Airways (ISRCTN: 18528625), funded by the National Institute for Health Research (NIHR), was designed to assess the feasibility of completing such a trial, comparing two second-generation supraglottic airway devices:

Subscribe to get full access to the Journal of Paramedic Practice

Thank you for visiting the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.

What's included

  • CPD Focus

  • Develop your career

  • Stay informed

Register
Or continue by

Signing in with your registered email address

Cardiac arrest
Airway management
Resuscitation
Pre-hospital care
Paramedics
Research