Advanced vs. Basic Airway Management Research Assignment (Research Paper Sample)

Advanced vs. Basic Airway Management
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Advanced vs. Basic Airway Management
The pre-hospital endotracheal intubation is recommended in patients with traumatic brain injury although it is often associated with significant complications including patient mortality (Davis et al., 2005; Bukur et al., 2011; Bossers et al., 2015). Studies conducted to investigate the correlation between advanced airway management such as endotracheal intubation and mortality rate indicate a higher probability of death in patients undergoing the procedure. Bukur et al. (2011) found that 90.2% of patients who underwent pre-hospital intubation lost their lives. Conversely, only 12.4% of patients who never underwent pre-hospital intubation succumbed to their injuries. Moreover, further analysis showed that pre-hospital intubation was an independent factor that increased the mortality rate of these patients. On the other hand, Bossers et al. (2015) found that the mortality rate of patients who undergo prehospital endotracheal intubation is largely influenced by the skill level of paramedics attending the trauma patients. Notably, research has confirmed that prehospital endotracheal intubation majorly contributes to the death of patients with traumatic brain injury although highly skilled paramedics can perform the procedure successfully.
Contrary to performing advanced airway management using endotracheal intubation or rapid sequence intubation, some scholars have suggested the need for simple airway control using the bag valve mask. Jabre et al. (2018) investigated the superiority of BVM over endotracheal intubation and found that both strategies are not significantly different with BVM having outcomes that are more adverse. Most importantly, since both ventilation and pre-hospital intubation have higher risks on the patient survival rate, the skill level of paramedics plays an important role. However, BVM easily performed by field paramedics and it enables oxygenation and improves ventilation in patients with moderate to severe traumatic brain injury before the patient is transferred to an experienced advanced life support provider for endotracheal intubation. Furthermore, research suggests that severe complications involving multiple organ failure in patients with severe head injury are observed more when endotracheal intubation is performed in the field as opposed to BVM. Therefore, in situations where endotracheal intubation is impossible to perform, BVM remains the most appropriate airway control method. While Davis et al. (2003) showed that paramedic intubation protocols resulted in negative results, the experience and training level of paramedics in emergency medical services is paramount to the survival rate of patients with traumatic brain injury. Lastly, since most of the EMS-providers are poorly trained and inexperienced, the advanced intubation techniques should be discouraged in EMS as they result in significantly high mortality rates.
References
Bossers, S. M., Schwarte, L. A., Loer, S. A., Twisk, J. W., Boer, C., & Schober, P. (2015). Experience in prehospital endotracheal in...