Cardiac arrest & resuscitation
Advanced Airway Device Use Order During Out-of-Hospital Cardiac Arrest
Authors' conclusion
In this cross-sectional study, most patients with OHCA received ETI as the first advanced airway procedure, despite higher SGA first-pass success. Among patients whose initial attempt failed, most continued with the same device. However, switching from ETI to SGA had a higher final success rates.
Study context
- Population
- Adults with out-of-hospital cardiac arrest (OHCA) treated during US emergency medical service (EMS) 911 activations with advanced airway attempts, National EMS Information System (NEMSIS) 2018–20232,365,224 OHCA activations
- Participants
- 650,440 adults
- Exposure
- Endotracheal intubation (ETI) vs supraglottic airway (SGA) as initial advanced airway device
- ETIn = 458,546
- Outcome
- Order of advanced airway device use (EMS clinician documentation)
Methodological detailsnational registry (NEMSIS)
- National registry (NEMSIS)
Main finding
As reported in the abstract
Initial device and first-pass success
Initial device and first-pass success ETI 70.5%
First-pass success
- Successful initial airway device attempt
- 503 774 [77.4%]
Observational data: associations, not effects.
Further findings
Final device after failed first ETI attempt
- First ETI attempt failed
- 133 177 of 458 546 [29.0%]
- Remained ETI
- 72 167 (72.3%)
- Changed to SGA
- 27 651 (27.7%)
Final device after failed first SGA attempt
- Remained SGA
- 13 480 (61.9%)
- Switched to ETI
- 3388 (38.1%)
Original publication
Advanced Airway Device Use Order During Out-of-Hospital Cardiac Arrest. JAMA Netw Open. Published 2 January 2026. doi:10.
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