The use of laryngeal tube by nurses in out-of-hospital emergencies: preliminary experience.
In out-of-hospital emergencies, including cardiac arrest, securing the airway and providing adequate lung ventilation are of paramount importance. Tracheal intubation is perceived as the gold standard technique and it is recommended by International Guidelines, but non skilled personnel often find the procedure difficult to achieve. Supraglottic devices are a good alternative in these situations, because they are superior to a bag-valve-mask for lung ventilation and offer better protection from aspiration. We have tested the laryngeal tube (LT) in out-of-hospital emergencies by minimally trained nurses. The LT was placed in 30 patients in cardiac arrest. LT insertion was successful within two attempts in 90% of patients, and ventilation was adequate in 80% of cases. No regurgitation occurred in any patient. The laryngeal tube remained in the correct position throughout resuscitation attempts in 93.3% of cases, while in two patients (6.6%) it became dislodged. In a subjective evaluation of the manoeuvre by nurses (ease of insertion, adequacy of ventilation, protection from aspiration), 86.7% of them expressed a positive opinion. The laryngeal tube appeared to be a reliable device for nurses to manage the airway in out-of-hospital emergencies.
Emergency Department, ASS 6 Friuli Occidentale, S. Vito al Tagliamento Hospital, 33078 S. Vito al Tagliamento (PN), Italy. fulvio.kette@ass6.sanita.fvg.it
Fulvio
F
Kette
Ingrid
I
Reffo
Giuseppina
G
Giordani
Fulvio
F
Buzzi
Vilma
V
Borean
Regina
R
Cimarosti
Alberto
A
Codiglia
Claudia
C
Hattinger
Alessandra
A
Mongiat
Sara
S
Tararan
D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation*; D004632:Emergency Medical Services / Q000379:methods*; D016529:Emergency Nursing; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D007558:Italy; D008297:Male; D008875:Middle Aged