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GWAS paramedics lead the way in airway research
2:39pm Friday 2nd March 2012 in Local
A major year-long study looking at different ways of managing the airway of patients suffering a cardiac arrest outside of hospital gets under way today.
The study – known as REVIVE Airways – involves 184 paramedics from across Great Western Ambulance Service (GWAS) treating patients in cardiac arrest in one of three ways.
Cardiac arrest is one of the most extreme medical emergencies; prompt and effective CPR (cardiopulmonary resuscitation) is essential to prevent damage to the patient’s brain and other organs, accompanied by managing the patient’s airway.
The continuing British Heart Foundation hands-only CPR campaign with Vinnie Jones highlights the importance of chest compressions for a patient in cardiac arrest and once the ambulance paramedic arrives at the scene then rapid airway management is needed to minimise disruption to chest compressions.
Among the current methods of airway management – and long regarded as the most effective – is tracheal intubation which involves placing a breathing tube in the patient’s windpipe.
However, this can cause significant complications and prolonged interruptions in chest compressions.
Therefore, alongside tracheal intubation, GWAS paramedics in the REVIVE Airways study will use one of two newer, supraglottic airway devices (SADs) – known as i-gel and LMAS.
These are quicker to insert and cause minimal interruption to chest compressions.
The paramedics have been divided into three groups – one will continue to manage cardiac arrest victims according to current paramedic skills, with the other two groups each trained in using one of the SADs.
Megan Rhys, GWAS research paramedic, said: "Over the years we have seen many advances in the field of medical equipment.
"However, research in pre-hospital care can be very challenging because by its very nature this is often in emergency situations where the focus is hands-on treatment of the patient.
"This is a real opportunity to find out how we can get meaningful results in the field of pre-hospital research.
"For us personally and professionally, it is very exciting to have such hands-on involvement in a major research project – ultimately this is about finding better ways to save the lives of more patients."
Also involved in the 12-month REVIVE Airways study are the University of the West of England and University Hospitals Bristol, with Professor Jonathan Benger and a number of other experts in the field of airway management, resuscitation and research.
The research is referred to as a ‘feasibility study’ because it is testing the way pre-hospital research is carried out.
It is planned that the results of the REVIVE Airways study will be used to pave the way for a future large-scale definitive study of the three methods of airway management.
Across GWAS about 100 patients a month receive CPR and advanced life support for cardiac arrest.
As part of the new Ambulance Quality Indicators (AQIs), ambulance services record how many cardiac arrest patients have a return of spontaneous circulation and how many of those subsequently survive and are discharged from hospital.