JEMS : a journal of emergency medical services
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Numerous studies addressing airway management in OHCA have shown a strong association between improved survival with treatment using BVM alone rather than with advanced airways. This BVM effect appears to persist despite variations in geographical region, patient population, and CPR quality. ⋯ Of note, the survival benefit with BVM alone vs. advanced airways doesn't appear in the pediatric population in the papers reviewed by the authors. The authors recommend that a prospective randomized study be conducted in order to explore this finding and to attempt to determine its causation.
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In airway procedures, preparation is 90% of success. For obese patients, positioning is 90% of this preparation. Other considerations include utilizing NIPPV and nasal cannula apneic oxygenation, utilizing multiple providers and airway adjuncts for BVM ventilation, correctly dosing medications based upon ideal, lean or total body weight, and having backup airway devices ready.