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A critical reassessment of ambulance service airway management in prehospital care: Joint Royal Colleges Ambulance Liaison Committee Airway Working Group, June 2008
  1. Charles D Deakin1,
  2. Tom Clarke2,
  3. Jerry Nolan3,
  4. David A Zideman4,
  5. Carl Gwinnutt5,
  6. Fionna Moore6,
  7. Michael Ward7,
  8. Carl Keeble8,
  9. Wim Blancke9
  1. 1South Central Ambulance Service, Otterbourne, UK
  2. 2Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
  3. 3Royal United Hospital NHS Trust, Bath, UK
  4. 4Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
  5. 5Salford Royal NHS Foundation Trust, Salford, UK
  6. 6London Ambulance Service NHS Trust, London, UK
  7. 7Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK
  8. 8East Midlands Ambulance Service NHS Trust, Nottingham, UK
  9. 9Frenchay Hospital, Frenchay, Bristol, UK
  1. Correspondence to Dr Charles D Deakin, South Central Ambulance Service, Southern House, Sparrowgrove, Otterbourne SO21 2RU, UK; charlesdeakin{at}


Paramedic tracheal intubation has been practised in the UK for more than 20 years and is currently a core skill for paramedics. Growing evidence suggests that tracheal intubation is not the optimal method of airway management by paramedics and may be detrimental to patient outcomes. There is also evidence that the current initial training of 25 intubations performed in-hospital is inadequate, and that the lack of ongoing intubation practice may compound this further. Supraglottic airway devices (eg, laryngeal mask airway), which were not available when extended training and paramedic intubation was first introduced, are now in use in many ambulance services and are a suitable alternative prehospital airway device for paramedics.

  • Airway
  • clinical assessment
  • competence
  • ECG
  • emergency ambulance systems
  • guidelines
  • paramedic
  • supraglottic airway
  • tracheal intubation
  • training

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  • Linked articles 088443, 090316, 090381.

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  • Competing interests CDD, TC, FM, CK, WB and MW are members of the Joint Royal Colleges Ambulance Liaison Committee Airway Working Group.

  • fn-4
  • Provenance and peer review Not commissioned; externally peer reviewed.

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