Emergency front-of-neck access in cardiac arrest: a scoping review
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Aljanoubi, MohammedAlmazrua, Abdulkarim A
Johnson, Samantha
Drennan, Ian R
Reynolds, Joshua C
Soar, Jasmeet
Couper, Keith
Publication date
2024-05-04
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Background: Airway management is a core component of the treatment of cardiac arrest. Where a rescuer cannot establish a patent airway to provide oxygenation and ventilation using standard basic and advanced airway techniques, there may be a need to consider emergency front-of-neck airway access (eFONA, e.g., cricothyroidotomy), but there is limited evidence to inform this approach. Objectives: This scoping review aims to identify the evidence for the use of eFONA techniques in patients with cardiac arrest. Methods: In November 2023, we searched Medline, Embase, and Cochrane Central to identify studies on eFONA in adults. We included randomised controlled trials, non-randomised studies, and case series with at least five cases that described any use of eFONA. We extracted data, including study setting, population characteristics, intervention characteristics, and outcomes. Our analysis focused on four key areas: incidence of eFONA, eFONA success rates, clinical outcomes, and complications. Results: The search identified 21,565 papers, of which 18,934 remained after de-duplication. After screening, we included 69 studies (53 reported incidence, 40 reported success rate, 38 reported clinical outcomes; 36 studies reported complications). We identified only one randomised controlled trial. Across studies, there was a total of 4,457 eFONA attempts, with a median of 31 attempts (interquartile range 16-56.5) per study. There was marked heterogeneity across studies that precluded any pooling of data. There were no studies that included only patients in cardiac arrest. Conclusion: The available evidence for eFONA is extremely heterogeneous, with no studies specifically focusing on its use in adults with cardiac arrest.Citation
Aljanoubi M, Almazrua AA, Johnson S, Drennan IR, Reynolds JC, Soar J, Couper K; International Liaison Committee on Resuscitation Advanced Life Support Taskforce. Emergency front-of-neck access in cardiac arrest: A scoping review. Resusc Plus. 2024 May 4;18:100653. doi: 10.1016/j.resplu.2024.100653.Type
ArticleOther
Additional Links
https://www.sciencedirect.com/journal/resuscitation-plusPMID
38716381Journal
Resuscitation PlusPublisher
Elsevierae974a485f413a2113503eed53cd6c53
10.1016/j.resplu.2024.100653