In comparison with bag-mask ventilation and use of a SGA, tracheal intubation requires considerably more training and practice and can result in unrecognised oesophageal intubation and increased hands-off time. A bag-mask, a SGA and a tracheal tube are frequently used in the same patient as part of a stepwise approach to airway management but this has not been formally assessed. 56 Patients who remain comatose after initial resuscitation from cardiac arrest will ultimately require tracheal intubation regardless of the airway technique used during cardiac arrest. Anyone attempting tracheal intubation must be well trained and equipped with waveform capnography. Personnel skilled in advanced airway management should attempt laryngoscopy and intubation without stopping chest compressions; a brief pause in chest compressions may be required as the tube is passed through the vocal cords, but this pause should be less than 5 seconds. In the absence of these, use bag-mask ventilation and/or an SGA until appropriately experience and equipped personnel are present.
There is no high quality evidence supporting one particular intervention over another. 2,57 Depending on the circumstances and the skills of the rescuers, use either an advanced airway (tracheal intubation or supraglottic airway (SGA)) or a bag-mask for airway management during CPR. 2,5