Cluster randomised 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
Cardiac arrest happens when the heart beat and breathing stop suddenly, and is one of the most extreme medical emergencies. The best initial treatment is cardiopulmonary resuscitation (CPR), a combination of rescue breathing and chest compressions. NHS ambulance staff currently provide rescue breathing by placing a breathing tube in the windpipe. This tube can cause significant complications as well as interruptions in chest compressions, which reduces delivery of blood and oxygen to the brain and heart. A newer method of rescue breathing involves the insertion of a supraglottic airway device (SAD); a tube that sits on top of the voice box. These are quicker to insert and cause less interruption to chest compressions. However, a SAD does not stay in place as securely as a breathing tube and, if a patient vomits, a SAD may not prevent stomach contents from entering their lungs. There is real uncertainty amongst paramedics and experts in the field about the best method to ensure a clear airway during the early stages of cardiac arrest.
The Airways-2 study is recruiting patients who have a cardiac arrest. Participants are allocated by chance to receive either the normal breathing tube or the newer SAD device, and followed up in hospital to determine their quality of life and the NHS resources they use during their hospital stay and subsequently.