Pre‐hospital airway management by non‐physicians in N orthern F inland – a cross‐sectional survey

Background Airway management is an important skill in pre‐hospital emergency medicine. The most optimal method depends on the resources and experience of the emergency medical service ( EMS ) providers. We wanted to study the frequency of occurrence, equipment used, problems experienced and maintenance of skills in pre‐hospital airway management by non‐physicians. Methods A structured questionnaire consisting of 30 questions was distributed to 383 EMS providers in three hospital districts (population 597,521 and area 147,467 km 2 ) in N orthern F inland. Results The questionnaire was answered by 226 EMS providers and 58.5% (224/383) were included in the final analyses. In all, 82.6% (185/224) of the EMS providers were allowed to perform endotracheal intubation ( ETI ) and 44.2% (99/224) could perform ETI using sedative agents. The annual mean frequency of using a supraglottic airway device ( SAD ) was 1.0 (range 0–20, n  = 224), for ETI it was 2.0 (range 0–16, n  = 185) and for bag‐valve‐mask ventilation it was 4.3 (range 0–30, n  = 223). The mean frequency of drug‐assisted ETI was 1.1 (range 0–13, n  = 99). Unsuccessful ETI had been experienced by 65.7% (119/181) of the EMS providers. Airway management had been practised in an operating room by 25.9% (56/216) and with a manikin by 81.3% (182/224) of the EMS providers during the past 12 months. Conclusion Advanced airway management procedures are uncommon for most EMS providers in N orthern F inland. Procedures, training in and maintenance of airway management skills should be re‐evaluated.