title: 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.
abstract: BACKGROUND
  Effective cardiopulmonary resuscitation with appropriate airway management improves outcomes following out-of-hospital cardiac arrest (OHCA). Historically, tracheal intubation has been accepted as the optimal form of OHCA airway management in the UK. The Joint Royal Colleges Ambulance Liaison Committee recently concluded that newer supraglottic airway devices (SADs) are safe and effective devices for hospital procedures and that their use in OHCA should be investigated. This study will address an identified gap in current knowledge by assessing whether it is feasible to use a cluster randomised design to compare SADs with current practice, and also to each other, during OHCA.
  
  
  METHODS
  The primary objective of this study is to assess the feasibility of a cluster randomised trial to compare the ventilation success of two newer SADs: the i-gel and the laryngeal mask airway supreme to usual practice during the initial airway management of OHCA. The secondary objectives are to collect data on ventilation success, further airway interventions required, loss of a previously established airway during transport, airway management on arrival at hospital (or termination of the resuscitation attempt), initial resuscitation success, survival to intensive care admission, survival to hospital discharge and patient outcome at 3 months. Ambulance paramedics will be randomly allocated to one of the three methods of airway management. Adults in medical OHCA attended by a trial paramedic will be eligible for the study.
  
  
  BACKGROUND
  Approval for the study has been obtained from a National Health Service Research Ethics Committee with authority to review proposals for trials of a medical device in incapacitated adults. The results will be made publicly available on an open access website, and we will publish the findings in appropriate journals and present them at national and international conferences relevant to the subject field.
  
  
  BACKGROUND
  ISRCTN: 18528625.
authors: Academic Department of Emergency Care,  The University Hospitals NHS Foundation Trust, Bristol,  UK.
authors: Jonathan Richard
authors: JR
authors: Benger
authors: Sarah
authors: S
authors: Voss
authors: David
authors: D
authors: Coates
authors: Rosemary
authors: R
authors: Greenwood
authors: Jerry
authors: J
authors: Nolan
authors: Steven
authors: S
authors: Rawstorne
authors: Megan
authors: M
authors: Rhys
authors: Matthew
authors: M
authors: Thomas