Intubation vs BVM in out of hospital cardiac arrest

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Well, it should never be advanced airway management vs providing ventilation...Unless, what you meant was, intubate, or just do BLS airways. 

This question isn't really a one word answer, and can get kind of complicated. 

Text book answers say, Intubation is the Gold Standard. Reason being, you can prevent gastric insufflation, which as we all know could lead to an airway disaster, and just general aspiration of secretions, and the text books are very correct in saying that.

But. Text books, again, as I'm sure you know (I'm not trying to be condescending), often ignore the reality of the streets; it's not uncommon that the situation simply doesn't allow you to. 

Also, you need to look at the cause of arrest. Was it primarily airway related? Then, yes, do everything you freaking can to get that tube. 

Or, do we suspect it's more cardiac in nature, where you still have some O2 reserve to play around with?

Either way, if you can't get a tube for some reason, there's no reason why an ALS provider shouldn't at least have a king airway (or whatever ALS Adjunct is preferred in whatever state). Most adjuncts have SOME degree of airway protection. Very little, and close to none, but it's better than just "hoping for the best".

A king airway takes basically no skill, and there's no reason why it can't be in every state's BLS Scope of Practice. 

If for some reason, I see an ALS provider only doing BLS airways on an arrest...they aren't technically wrong, but I'll still stand there and roll my eyes unless they have a VERY good reason why 



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58 minutes ago, cekuriger said:

Unless, what you meant was, intubate, or just do BLS airways. 




Unless, what I meant by actually posting a link to the study, was that you read it.  The study looks at outcomes.  Take a few minutes to review the abstract.  Not entirely sure where you're coming up with the things on which you're commenting.

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