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Emergency Airway Placement by EMS Providers: Comparison between the King LT Supralaryngeal Airway and Endotracheal Intubation

Published online by Cambridge University Press:  28 June 2012

J. Bracken Burns Jr. ,
Richard Branson ,
Stephen L. Barnes  and
Betty J. Tsuei
J. Bracken Burns Jr.*
Affiliation:
University of Florida College of Medicine-Jacksonville, Department of Surgery, Jacksonville, Florida, USA
Richard Branson
Affiliation:
University of Cincinnati College of Medicine, Department of Surgery, Cincinnati, Ohio, USA
Stephen L. Barnes
Affiliation:
University of Missouri School of Surgery, Columbia, Missouri, USA
Betty J. Tsuei
Affiliation:
University of Cincinnati College of Medicine, Department of Surgery, Cincinnati, Ohio, USA
*
Division of Acute Care SurgeryDepartment of SurgeryUniversity of Florida-Jacksonville655 West Eighth StreetJacksonville, Florida 32209USA E-mail: bracken.burns@jax.ufl.edu
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Abstract

Introduction:

The ever-present risk of mass casualties and disaster situations may result in airway management situations that overwhelm local emergency medical services (EMS) resources. Endotracheal intubation requires significant user education/training and carries the risk of malposition. Furthermore, personal protective equipment (PPE) required in hazardous environments may decrease dexterity and hinder timely airway placement. Alternative airway devices may be beneficial in these situations.

Objective:

The objective of this study was to evaluate the time needed to place the King LT Supralaryngeal Airway compared to endotracheal intubation when performed by community EMS personnel with and without PPE.

Methods:

Following training, 47 EMS personnel were timed placing both endotracheal tubes and the King LT supralaryngeal airway in a simulator mannikin. The study participants then repeated this exercise wearing PPE.

Results:

The EMS personnel wearing PPE took significantly longer to place an endotracheal tube than they did without protective equipment (53.4 seconds and 39.5 seconds, p <0.002). The time to place the King LT was significantly faster than the placement of the endotracheal tube without protective equipment (18.4 seconds and 39.5 seconds, respectively, p<0.00003). There also were statistically significant differences between the time required to place the King LT and endotracheal tube in EMS personnel wearing protective equipment (19.7 seconds and 53.4 seconds, p <0.000007).

Conclusions:

The King LT Supralaryngeal Airway device may be advantageous in prehospital airway management situations involving multiple patients or hazardous environments. In this study, its insertion was faster than endotracheal intubation when performed by community EMS providers.

Keywords

airwayemergency medical services (EMS)endotracheal intubationKing LT Supralaryngeal Airway
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 1 , February 2010 , pp. 92 - 95
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

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References

1.Asai, T, Murao, K, Shingu, K: Efficacy of the laryngeal tube during intermittent positive-pressure ventilation. Anaesthesia1 2000;55(11):1099–1102.CrossRefGoogle ScholarPubMed
2.Doerges, V, Ocker, H, Wenzel, V, Schmucker, P: The laryngeal tube:A new simple airway device. Anesth Anal 2000;90(5):1220–1022.CrossRefGoogle Scholar
3.Hagberg, C, Bogomolny, Y, Gilmore, C, Gibson, V, Kaitner, M, Khurana, S: An evaluation of the insertion and function of a mew supraglottic airway device, the King LT, during spontaneous ventilation. Anesth Analg 2006;102(2):621–625.CrossRefGoogle Scholar
4.Goldik, Z, Bornstein, J, Eden, A, Ben-Abraham, R: Airway management by physicians wearing anti-chemical warfare gear: Comparison between laryngeal mask airway and endotrachealintubation. Eur J Anaesthesiol 2002;19(3):166–169.CrossRefGoogle Scholar
5.McManus, J, Parsons, D, Proulx, C, Cain, J, Hill, G. Combat trauma airway management: Combitube versus the King laryngeal tracheal device by Army combat medic students. Acad Emerg Med 2005;12; Suppl 1:162.Google Scholar
6.Asai, T, Matsumoto, S, Shingu, K, Noguchi, T, Koga, K: Useof the laryngeal tube after failed insertion of a laryngeal mask airway. Anesthesia 2005;60(8):825–826.CrossRefGoogle Scholar
7.Gaitini, L, Vaida, S, Somri, M: An evaluation of the laryngeal tube duringgeneral anesthesia using mechanical ventilation. Anesth Analg 2003;96(6):1750–1755.CrossRefGoogle ScholarPubMed
8.Asai, T, Kawashima, A, Hidaka, I, Kawachi, S: The laryngeal tube compared with the laryngeal mask: insertion, gas leak pressure and gastric insufflation. Br J Anaesth 2002;89(5):729–732.CrossRefGoogle ScholarPubMed
9.Ochs, M, Vilke, G, Chan, T, Moats, T, Buchanan, J: Successful prehospital airway management by EMT-Ds using the Combitube. Prehosp Emerg Care 2000;4(4):333–337.CrossRefGoogle ScholarPubMed