Application safety of airway devices by German paramedics

Introduction: There is debate about which airway devices are best used by German paramedics – particularly extraglottic airway devices (EGA) – but the perceived application safety of the user has not been considered. Method: In July and August 2023, an online questionnaire developed by the authors was distributed among German paramedics and results were analysed descriptively. Differences between supplementary-trained (ST) and fully trained (FT) paramedics were determined using the Welch test. Factors for developing application safety when using laryngeal tubes (LT) and laryngeal masks (LMA) were analysed using logistic regression. Results: 780 data records were included. Participants have 13.6 years of professional experience (SD 9.1) and 33.0% have completed full-time training. Oropharyngeal tubes and nasopharyngeal tubes were used most frequently in the last 12 months. ST performed significantly better than FT in terms of self-perceived application safety of the use of LT, conventional (cETI) and video-assisted endotracheal intubation (vETI), puncture cricothyrotomy (PC), and overall self-perceived safety. In the logistic regression, years of professional experience ( p =0.003; OR 0.95), ST ( p <0.001; OR 3.68) and use of the simulator ( p =0.048; OR 1.024) had a significant effect on the safety of LT use. Use on the simulator ( p <0.001; OR 1.05) and real patient ( p <0.001; OR 1.08) had significant effects on the self-perceived application safety of the LMA. Conclusion: Results show a differentiated picture of self-perceived application safety, particularly EGA. ST paramedics feel more confident using airway devices than FT colleagues.