Prehospital Airway Control Trial (PACT)

This research study, called:  "PACT: Prehospital Airway Control Trial," will compare different ways to help people with traumatic injuries (car accidents, falls, work accidents for example) breathe.  Between 8% and 15% of people with traumatic injuries die because they didn't get good enough help breathing.  Currently, prehospital providers typically use one of two methods to help people breathe; one is with a tube in the windpipe, called an endotracheal (ET) tube, and the other is with a device that sits over the windpipe called a supraglottic airway (SGA).  Although both methods are currently used, we think that the SGA may be better.  To test this, we will ask some providers to use whatever method they would normally use and some providers to try using the SGA first, and we will compare the two groups.  Regardless of the study, the injured person would stil need help breating and would likely receive one of these two methods anyway. 

Both methods of airway help are considered standard care.  ET tubes are used by many Emergency Medical Services (EMS) as their first choice, but placing an ET tube is complicated and takes advanced skill.  Studies have shown that a provider needs to put in 10 or more ET tubes to become good at it, and they need to do 5-12 per year to stay good at it.  However, most providers put in less than 2 a year.  In contrast, SGAs have been proven to need less practice and are much quicker to put in.  They are also easier to use and don't require the same equipment needed to put in an ET tube.

People who are included in studies looking at emergency treatments like this one are really sick, many are unconscious, and they cannot give us permission to include them in the study beforehand.  It is very important to quickly help people to breathe when they need it.  Because we have to help the person breathe right away, we do not have time to ask family for permission before we include someone.  We do tell the person or their family as soon as we can that they are in the study and give them a chance to decide if they want to keep participating.  Emergency studies like this one follow special rules and are reviewed by several groups of people to make sure that the study does not take advantage of very sick people and that the possible benefits to the person or to society outweigh the risks. 

If you would like to talk to someone more about the study or if you have any questions, please email or visit for more information.