Opinion EDITORIAL Roger J. Lewis, MD, PhD; Marianne Gausche-Hill, MD In this issue of JAMA, Jabreetal report the results of an dure in the out-of-hospital setting and most paramedics have ambitious randomized noninferiority trial comparing bag- limited opportunities to use this skill in practice. mask ventilation (BMV) with endotracheal intubation (ETI) In contrast, European physicians working in ambulances usually also work in hospital-based settings in which ETI is more in the treatment of 2043 adult 13-15 patients who experienced commonly performed. This creates uncertainty if the re- Related article page 779 cardiac arrest in the out-of- sults of the Belgian and French experience reported by Jabre hospital setting, with a primary dichotomous outcome of sur- et al can inform decisions regarding the use of ETI in the United vival with favorable neurological outcome. During the trial, States. However, although systems that have physicians work- performed in France and Belgium, 4.3% of patients treated with ing in the out-of-hospital setting may seem optimal, they have BMV (n = 1020) compared with 4.2% of patients treated with not demonstrated superior skill performance nor improved out- ETI (n = 1023) achieved the primary outcome, defined as favor- comes for patients with cardiac
JAMA – American Medical Association
Published: Feb 27, 2018
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