Airway management is a critical component of resuscitation during out-of-hospital cardiac arrest (OHCA). A retrospective analysis published in Resuscitation examined trends in supraglottic airway (SGA) placement by emergency medical technicians (EMTs) and compared procedural outcomes with paramedic placement.
The study analyzed National Emergency Medical Services Information System (NEMSIS) data from 2019 to 2023 and included adult OHCA cases in which SGA insertion was attempted on the first airway attempt. Cases were stratified by airway provider credential (EMT or paramedic), and mixed-model logistic regression was used to evaluate first-pass success (FPS).
A total of 189,307 OHCA cases involved SGA placement, including 41,035 (21.7%) performed by EMTs and 148,272 (78.3%) by paramedics. EMT-performed placements increased from 3,140 cases (20.6%) in 2019 to 10,371 cases (23.3%) in 2023 (p < 0.01), while the number of Emergency Medical Services (EMS) agencies reporting EMT SGA placement rose from 664 (38.0%) to 1,525 (51.7%).
First-pass success rates were similar between EMTs and paramedics (93.7% vs 94.3%; adjusted odds ratio [aOR] 0.93; 95% CI 0.89–0.98). Overall, both the proportion of SGAs placed by EMTs and the number of EMS agencies allowing EMT SGA placement increased during the study period.