A comparison of the laryngeal tube and bag-valve mask ventilation by emergency medical technicians: a feasibility study in anesthetized patients.
Airway management is of major importance in emergency care. The basic technique for all health care providers is bag-valve mask (BVM) ventilation, which requires skill and may be difficult to perform. Endotracheal intubation, which is the advanced method for securing the airway, is a demanding technique that has been shown to be associated with infrequent success, even when used by experienced paramedical personnel. Therefore, alternative airway devices have been sought. The use of the laryngeal tube (LT) by experienced anesthesia personnel had been studied in anesthetized patients and manikins in emergency medical training. We decided to evaluate the ability of inexperienced firefighter-emergency medical technician students (fire-EMT) to insert the LT or perform BVM in anesthetized patients. Thirty fire-EMTs randomly inserted the LT (n = 15) and performed 1 min of ventilation or used the BVM (n = 15). We found that all students successfully (100%) inserted the LT. Those who inserted the LT on the first attempt (73%) required 48.2 +/- 14.7 s for the insertion. Both the LT and BVM provided adequate oxygenation and ventilation. In this study, we found that inexperienced fire-EMT students inserted LT and performed 1-min ventilation with a reasonable success rate and insertion time in anesthetized patients.
Kurola
Jouni O
JO
*Department of Anaesthesia and Intensive Care, Kuopio University Hospital; †Emergency Services College, Kuopio; and ‡Department of Anaesthesia and Intensive Care Medicine, Helsinki University Central Hospital, Finland.
Turunen
Matti J
MJ
Laakso
Juha-Pekka
JP
Gorski
Jouko T
JT
Paakkonen
Heikki J
HJ
Silfvast
Tom O
TO
D000328:Adult; D000368:Aged; D000758:Anesthesia; D004634:Emergency Medical Technicians; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D017214:Laryngeal Masks; D008875:Middle Aged; D012121:Respiration, Artificial