Leah Duncan, B.S., Michael Falahat, M.D., Connor Hartpence, M.D., Deryk S. Ruddle, B.S., EMT-P, Samuel Ofei-Dodoo, Ph.D., MPA, M.A.
University of Kansas School of Medicine-Wichita, Wichita, KS; Department of Family and Community Medicine; Family Medicine Residency Program at Ascension Via Christi Hospital; Spira Care, Olathe, KS; Wichita/Sedgwick County Office of the Medical Director, Wichita, KS
ABSTRACT:
When emergency medical services (EMS) personnel respond to emergencies, the decisions they make often can mean life or death for the patient. This is especially true in the case of advanced airway management. Protocols are set in place to ensure that the least invasive airway management techniques are used initially before more invasive techniques. The purpose of this study was to determine how often EMS personnel followed this protocol.
The authors reviewed the Wichita/Sedgewick County EMS system for cases during 2017 in which patients required airway support. We examined de-identified data to determine if invasive methods were applied in sequence.
279 cases were identified in which EMS personnel used advanced airway management techniques. In 90% (n = 251) of cases, less invasive techniques were not used prior to more invasive techniques and in 80% (n = 222) of cases, the more invasive technique was used alone. A dirty airway was the most common reason for the EMS personnel's choice of using more invasive methods initially.
Our data showed that EMS personnel in Sedgwick County/Wichita, Kansas often deviated from the advanced airway management protocol when caring for patients in need of respiratory intervention. It is important to understand reasons why deviations in protocol occur to ensure that current protocols, documentation, and training practices are effective in producing the best possible patient outcomes.
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