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EMS1 readers weigh in on adding supraglottic airways to the EMT scope of practice
In a recent article, EMS MEd Editor Maia Dorsett presented a case for including supraglottic airway placement in the EMT scope of practice, based on comments received in an NAEMSP discussion forum.
After reading the article, EMS1 readers weighed in with their own experiences and opinions on the topic.
Do you think EMTs should be trained and certified to perform this skill? Let us know in the comments and we may add your comments to the list.
“Yes, we let them ventilate patients once an airway is placed, so them placing something like an iGel should in their scope. It’s not an ET tube, so there is not a huge learning curve. ABCs of patient care should be everyone’s responsibility.” — Clint Christiansen
“When I became an EMT, it was part of NREMT skills for a basic to intubate patients. I never used that skill as a basic, as it was taken out of scope the following year. Supraglottic airways, however, could mean life or death in rural areas where volley squads are still utilized if it’s only basics responding.” — Ashlee Kay Bradley
“With proper training, absolutely! The management of an airway, especially in a cardiac arrest, should be BLS. All the research is pointing to supraglottic airways in prehospital care. Intubation has its place but should be reserved for viable patients who will have clinical benefit from the airway placement.” — Brad Borkowski
“[South Carolina] has had EMTs using supraglottic airways for quite some time now. As long as you’re properly training your people, it’s nothing to be fearful of. Airway management is a basic skill, by and large, anyway.” — Jamie White
“NO! If we keep adding things to the EMT scope of practice, pretty soon they will be really bad paramedics. Let EMTs be EMTs.” — Daniel S. Syme
“At least 1/2 the EMTs I work with still don’t know when to give or NOT give Narcan … the idea that these guys could have access to an LMA is downright scary!” — Rena Levine Berns
“Yes. Without a doubt. They can in Iowa. You know how difficult it is to maintain a mask seal and most are doing it with one person. This eliminates that. I’d like to see an outcome study in BVM vs. supraglottic airway placement in noncardiac arrest patients.” — Jeff Messerole
“Absolutely! There’s still medics out there gut tubing patients. I don’t see why EMTs can have a go at it. EMTs are totally underutilized.” — Andrea Marquez
“It’s already within scope in South Carolina. I think it’s a great option, especially for rural areas where they may have limited access to a medic … prolonging airway management while waiting a medic is not proactive care for your patients.” — Tamara Yoder
“EMTs should be able to use any airway device that doesn’t require the use of a laryngoscope.” — James Smith
“Absolutely! It’s not complicated, and it’s always better to have an extra set of trained hands, whether they’re part of a team or by themselves. Options are always good.” — Igor Vidovic
“Recently got added to the EMT-B scope of practice in Alabama, it has been a great addition to our rural service when we have lots more basic EMTs than medics.” — Christopher Espy
“Already in the scope. Should not be a question, they are not difficult to place and have few contraindications. They’re already pushing many other frivolous topics, why not focus on something that could saves lives vs. be used to create a limiting policy. NREMT needs to step up to create a better curriculum with easier licensing option with reciprocity everywhere.” — Ryan Jolly
“It’s standard practice in Oklahoma, but we are the wild west, so there’s that.” — Brandon Mathews
“Absolutely. It’s an outstanding form of airway that is safe and efficient if done correctly. If any basic truck arrives on scene to a patient requiring a more advanced airway than a BVM, you can proceed to do that until ALS intervention has taken place.” — Hunter Pepper
How much do you really know about supraglottic airway management uses, contraindications and techniques?
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Rachel Engel is the senior associate editor of FireRescue1.com and EMS1.com. In addition to her regular editing duties, Engel seeks to tell the heroic, human stories of first responders and the importance of their work. She earned her bachelor's degree in communications from Cameron University in Lawton, Oklahoma, and began her career as a freelance writer, focusing on government and military issues. Engel joined Lexipol in 2015 and has since reported on issues related to public safety. Engel lives in Wichita, Kansas. She can be reached via email.
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