Airway management in UK ambulance services: results of the National Ambulance Service Airway Management Audit

Aim:To establish the range of airway devices provided to ambulance staff employed by the UK NHS ambulance services, which level of practitioner is allowed to use which device or intervention, and what the main factors were in the purchasing decisions taken.Methods:Medical directors from all 14 UK NHS ambulance services were invited to participate in an anonymous, web-based survey of emergency airway management equipment provided within their service and which grades of practitioner were authorised to use the equipment they provided. Additionally, they were asked for the main reasons for the purchase of the selected equipment.Results:All 14 ambulance services completed the survey questionnaire. A range of clinical grades is now employed by UK ambulance services although there is inconsistency in both title and skill set. All services provide a range of airway equipment, but there is no common inventory across UK ambulance Trusts. Nearly all staff were authorised to use some of the basic equipment, but wider variations appear with more complex or sophisticated techniques. In particular there appears to be significant gaps in advanced equipment and those authorised to use it in respect of children.Conclusions:The range of airway equipment and those authorised by ambulance services to undertake airway management interventions appears to be evolving. It is of concern that there remains an apparent lack of standardisation of the range of airway equipment provided by UK NHS ambulance services.

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