Airway management is the foundation of prehospital emergency care. Emergency medical services (EMS) practice now includes a range of airway techniques. However, evidence is still lacking as to which of these airway management approaches under which circumstances have the best outcomes.
To address this issue, the National Association of State EMS Officials (NASEMSO) has been leading a project that recently published an Evidence-Based Guideline (EBG) for Prehospital Airway Management.
Evidence-based guidelines are created for many reasons, but one of the most critical is that they make it easier for EMS medical directors, leaders and clinicians to provide the most appropriate care—even if they don’t have the time or expertise to read, interpret and synthesize the available evidence.
The EBG for Prehospital Airway Management offers EMS providers an opportunity to review and update their airway management strategies.
The EBG makes 22 recommendations on the use of three airway management approaches: bag-valve mask, supraglottic airway, and endotracheal intubation. The three approaches were assessed for two populations (adults and children) and for three types of emergency medical events (cardiac arrest, medical emergencies, and trauma). Additional recommendations address the use of video laryngoscopy and drug-assisted airway management.
Appendix A of the EBG operationalizes the recommendations into a set of Good Practice Statements.
The evidence used to develop these recommendations comes from a systematic review by the Agency for Healthcare Research and Quality (AHRQ) in 2021. The systematic review assessed comparative benefits and harms of these three airway management approaches in various circumstances, based on findings from 99 studies involving 630,397 patients.
This publication is part of a larger project led by NASEMSO through a cooperative agreement with the National Highway Traffic Safety Administration’s Office of EMS (NHTSA OEMS), in partnership with the American College of Emergency Physicians® (ACEP), the National EMS Quality Alliance (NEMSQA), and the National Registry of EMTs® (NREMT).
In accordance with NHTSA OEMS’ National Prehospital Evidence-Based Guideline Model Process, this EBG will be used as a basis for a model protocol for prehospital airway management. The project outcomes will also include associated quality measures and educational materials to help distribute the EBG and model protocol to EMS clinicians and EMS medical directors.
The EBG for Prehospital Airway Management; the methodology for its development; an article summarizing the EBG, its significance, and future direction; and the 2021 systematic review were published in the journal Prehospital Emergency Care.
Learn more about the larger Prehospital Airway Management Evidence Based Guideline project on NASEMSO’s website. Access all EBGs and related documents on EMS.gov.
(Sources: Prehospital Emergency Care, NHTSA OEMS, NASEMSO, AHRQ)
In November 2022, the Department of Energy’s Argonne National Laboratory (ANL), the Federal Emergency Management Agency (FEMA) and AT&T announced the launch of a new website with the goal of helping communities prepare for future climate extremes.
Since the 2022 launch, the Climate Risk and Resilience Portal (ClimRR) has established itself as an award-winning, free, national online source for sophisticated climate data down to the neighborhood level.
Community leaders, infrastructure managers, civil engineers and public safety officials can use ClimRR to build resilience against the impacts of future climate hazards like extreme heat, heavy rainfall, wildfire, and drought. This climate-related hazard data can be integrated with local demographic and infrastructure data, so that data on future conditions can be incorporated into Hazard Mitigation Plans, land use plans, infrastructure design, and FEMA’s Resilience Analysis and Planning Tool (RAPT).
Last month, a major update to ClimRR was released. FEMA, ANL, and AT&T hosted a webinar on Feb. 1 on how to use ClimRR’s newly enhanced features. This webinar was recorded and is now available on demand via ANL’s YouTube channel. The webinar showed participants how to:
- Generate a local report assessing future climate hazards and community impacts. The new climate projection page allows you to customize a report for your area, combining variables like population demographics with hazard projections.
- Access maps, charts and visualizations. Create easy-to-understand maps, charts and graphs so you can quickly find and communicate important climate risks facing your community.
- Interpret climate hazard data points. Climate data can be overwhelming to explain and understand. Using the portal’s educational features, participants will learn to identify communities most at risk.
Access the ClimRR Portal and learn more about the latest updates at climrr.anl.gov.
(Sources: ANL, FEMA)
The National Volunteer Fire Council (NVFC) will host a Roundtable Talk on Tuesday, Feb. 27 at 2 p.m. EST entitled Lessons Learned: Reflecting on the East Palestine Derailment and the Path Forward.
Just over one year ago, on the evening of February 3, 2023, an eastbound Norfolk Southern Railway freight train derailed 38 railcars in East Palestine, Ohio. The incident received national media attention due to public health concerns about the hazardous materials release, which included vinyl chloride, a liquified compressed gas that is flammable, highly toxic, and a known carcinogen.
The incident also drew attention to the importance of getting real-time information to first responders about the hazards at the scene. About 300 firefighters from 50 departments initially responded to the scene of the derailment in East Palestine on the night of February 3. Many of them were volunteers.
The National Transportation Safety Board thoroughly investigated the accident in East Palestine, and their final report is forthcoming.
In this Roundtable Talk, participants will hear from panelists Keith Drabick of the East Palestine Fire Department, Dan Seidberg of IamResponding, and John Fleps of Norfolk Southern. The conversation will be moderated by the NVFC’s Ryan Woodward.
This Roundtable Talk will be streamed live on Facebook and Zoom. To join, visit the Facebook Live page for this event at the scheduled time, or register to attend via Zoom.
(Source: NVFC)
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