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Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2016

Open Access 01-12-2016 | Original research

An exploration of the views of paramedics regarding airway management

Authors: Janet Brandling, Megan Rhys, Matthew Thomas, Sarah Voss, Sian Emma Davies, Jonathan Benger

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2016

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Abstract

Background

Paramedics are a skilled group of clinicians with expertise in airway management. Our research group has completed a trial comparing supraglottic airway devices with tracheal intubation during out of hospital cardiac arrest. This is a contentious topic amongst paramedics in the United Kingdom (UK). We explored the customs and beliefs of UK paramedics in relation to airway management, and whether tracheal intubation contributes to and sustains paramedic professional identity.

Methods

The study took place within South Western Ambulance Service NHS Foundation Trust. We used a qualitative approach, conducting interviews and focus groups with paramedics. The themes arising from interviews were discussed in focus groups, developing a deeper understanding and providing insight and recommendations for future research and policy. Purposive sampling accounted for differing training and for participation in the main trial. There were 17interviews and five focus groups with a further 17 participants. Data saturation was achieved.

Results

Four domains were identified. Pride - The ability to use a life-saving skill in austere conditions. Utility - Different training routes and experience have led to different attitudes towards airway management. Inconsistent expectations - Paramedics felt that there were different perceptions of their abilities amongst hospital staff and the general public. Professionalization - Debate over airway management is not founded on good evidence.

Conclusion

We have demonstrated that UK paramedics have a wide range of views regarding airway management, and that these are based on evidence and experience rather than dogma. Airway management contributes to paramedics’ professional identity, but is not reliant on this.
Literature
1.
go back to reference Fothergill RT, Watson LR, Chamberlain D, Virdi GK, Moore FP, Whitbread M. Increases in survival from out-of-hospital cardiac arrest: a five year study. Resuscitation. 2013;84:1089–92.CrossRefPubMed Fothergill RT, Watson LR, Chamberlain D, Virdi GK, Moore FP, Whitbread M. Increases in survival from out-of-hospital cardiac arrest: a five year study. Resuscitation. 2013;84:1089–92.CrossRefPubMed
3.
go back to reference Benger JR, Voss S, Coates D, et al. Randomised comparison of the effectiveness of the laryngeal mask airway supreme, i-gel and current practice in the initial airway management of prehospital cardiac arrest (REVIVE-Airways): a feasibility study research protocol. BMJ Open 2013;3:e002467. http://dx.doi.org/10.1136/bmjopen-2012-002467. Benger JR, Voss S, Coates D, et al. Randomised comparison of the effectiveness of the laryngeal mask airway supreme, i-gel and current practice in the initial airway management of prehospital cardiac arrest (REVIVE-Airways): a feasibility study research protocol. BMJ Open 2013;3:e002467. http://​dx.​doi.​org/​10.​1136/​bmjopen-2012-002467.
4.
go back to reference Lyon RM, Ferris JD, Young DM, McKeown DW, Oglesby AJ, Robertson C. Field intubation of cardiac arrest patients: a dying art? Emerg Med J. 2010;27:321–3.CrossRefPubMed Lyon RM, Ferris JD, Young DM, McKeown DW, Oglesby AJ, Robertson C. Field intubation of cardiac arrest patients: a dying art? Emerg Med J. 2010;27:321–3.CrossRefPubMed
5.
go back to reference Joint Royal Colleges Ambulance Liaison Committee (JRCALC) Airway Working Group. A critical reassessment of ambulance service airway management in pre-hospital care. London: JRCALC; 2008. Joint Royal Colleges Ambulance Liaison Committee (JRCALC) Airway Working Group. A critical reassessment of ambulance service airway management in pre-hospital care. London: JRCALC; 2008.
6.
go back to reference Woollard M, Furber R. The College of Paramedics (British Paramedic Association) position paper regarding the Joint Royal Colleges Ambulance Liaison Committee recommendations on paramedic intubation. Emerg Med J. 2010;27:167–70. doi:10.1136/emj.2009.088443.CrossRefPubMed Woollard M, Furber R. The College of Paramedics (British Paramedic Association) position paper regarding the Joint Royal Colleges Ambulance Liaison Committee recommendations on paramedic intubation. Emerg Med J. 2010;27:167–70. doi:10.​1136/​emj.​2009.​088443.CrossRefPubMed
7.
go back to reference Burford B, Morrow G, Rothwell C, Carter M, Illing J. Professional education should reflect reality: findings from three health professions. Med Ed. 2014;48:361–74.CrossRef Burford B, Morrow G, Rothwell C, Carter M, Illing J. Professional education should reflect reality: findings from three health professions. Med Ed. 2014;48:361–74.CrossRef
8.
go back to reference Williams B, Onsman A, Brown T. Professionalism. From stretcher-bearer to paramedic: the Australian paramedics’ move towards professionalism. J Emerg Prim Health Care. 2009;7:4. Williams B, Onsman A, Brown T. Professionalism. From stretcher-bearer to paramedic: the Australian paramedics’ move towards professionalism. J Emerg Prim Health Care. 2009;7:4.
9.
go back to reference O’Meara P. Paramedics marching towards professionalism. J Emerg Prim Health Care. 2009;7(1):1–5. O’Meara P. Paramedics marching towards professionalism. J Emerg Prim Health Care. 2009;7(1):1–5.
10.
go back to reference McCann L, Granter E, Hyde P, Hassard J. Still blue-collar after all these years? An ethnography of the professionalization of emergency ambulance work. Manag Stud. 2013;50(5):750–76.CrossRef McCann L, Granter E, Hyde P, Hassard J. Still blue-collar after all these years? An ethnography of the professionalization of emergency ambulance work. Manag Stud. 2013;50(5):750–76.CrossRef
11.
go back to reference Morrow G, Burford B, Rothwell C, Carter M, McLachlan J, Illing J. Professionalism in Healthcare Professionals. Report to the Health and Care Professions Council. London: HCPC; 2011. Morrow G, Burford B, Rothwell C, Carter M, McLachlan J, Illing J. Professionalism in Healthcare Professionals. Report to the Health and Care Professions Council. London: HCPC; 2011.
12.
go back to reference Pollock MJ, Brown LH, Dunn KA. The perceived importance of paramedic skills and the emphasis they receive during EMS education programs. Prehosp Emerg Care. 1997;1(4):263–8.CrossRefPubMed Pollock MJ, Brown LH, Dunn KA. The perceived importance of paramedic skills and the emphasis they receive during EMS education programs. Prehosp Emerg Care. 1997;1(4):263–8.CrossRefPubMed
13.
go back to reference Boyce Thomas J, Abo BN, Wang HE. Paramedic perceptions of challenges in out-of-hospital tracheal intubation. Prehosp Emerg Care. 2007;11:219–23.CrossRef Boyce Thomas J, Abo BN, Wang HE. Paramedic perceptions of challenges in out-of-hospital tracheal intubation. Prehosp Emerg Care. 2007;11:219–23.CrossRef
14.
go back to reference Braun V, Clark V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef Braun V, Clark V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRef
15.
go back to reference Head E. The ethics and implications of paying participants in qualitative research. Int J Soc Res Methodol. 2009;12(4):335–44.CrossRef Head E. The ethics and implications of paying participants in qualitative research. Int J Soc Res Methodol. 2009;12(4):335–44.CrossRef
16.
go back to reference Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Methods. 2006;18:59–81.CrossRef Guest G, Bunce A, Johnson L. How many interviews are enough? An experiment with data saturation and variability. Field Methods. 2006;18:59–81.CrossRef
17.
go back to reference Tanabe S, Ogawa T, Akahane M, Koike S, Horiguchi H, Yasunaga H, et al. Comparison ofneurological outcome between tracheal intubation and supraglottic airway device insertion of out-of-hospital cardiac arrest patients: a nationwide, population-based, observational study. J Emerg Med. 2013;44:389–97.CrossRefPubMed Tanabe S, Ogawa T, Akahane M, Koike S, Horiguchi H, Yasunaga H, et al. Comparison ofneurological outcome between tracheal intubation and supraglottic airway device insertion of out-of-hospital cardiac arrest patients: a nationwide, population-based, observational study. J Emerg Med. 2013;44:389–97.CrossRefPubMed
18.
go back to reference First S, Tomlins L, Swinburn A. From trade to profession-the professionalisation of the paramedic workforce. Journal of Paramedic Practice. 2012;4(7):378–81.CrossRef First S, Tomlins L, Swinburn A. From trade to profession-the professionalisation of the paramedic workforce. Journal of Paramedic Practice. 2012;4(7):378–81.CrossRef
19.
go back to reference Soar J, Nolan JP. Airway management in cardiopulmonary resuscitation. Curr Opin Crit Care. 2013;19(3):181–7.CrossRefPubMed Soar J, Nolan JP. Airway management in cardiopulmonary resuscitation. Curr Opin Crit Care. 2013;19(3):181–7.CrossRefPubMed
20.
go back to reference Woollard M. Professionalism in UK paramedic practice. AJP. 2009;7(4). Woollard M. Professionalism in UK paramedic practice. AJP. 2009;7(4).
Metadata
Title
An exploration of the views of paramedics regarding airway management
Authors
Janet Brandling
Megan Rhys
Matthew Thomas
Sarah Voss
Sian Emma Davies
Jonathan Benger
Publication date
01-12-2016
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-016-0243-2

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