Use of the King LTS-D during medication-assisted airway management.
OBJECTIVE
This case series evaluated provider use of the King LTS-D as a primary airway in patients requiring rapid-sequence intubation (RSI).


METHODS
Twenty-seven paramedics completed a one-hour training session on the use of the device. All patients meeting the service's standard criteria for medication-assisted airway management were included in the study. Following each insertion, paramedics contacted a research hotline to complete data collection. The primary endpoint was successful insertion, with secondary endpoints including time from succinylcholine administration to successful ventilation, pre- and post-insertion vital signs (oxygen saturation [SaO(2)], pulse rate, and systolic and diastolic blood pressure), and end-tidal carbon dioxide [ETCO(2)] value 2 minutes after insertion. Analysis between pre- and postinsertion variables was completed using the Wilcoxon signed-rank test.


RESULTS
A total of 11 patients met the enrollment criteria and were treated with the device by nine of the 27 paramedics enrolled in the study. All 11 insertions (100%) were successful, with 10 of the 11 (91%) successes achieved on the first insertion attempt. No significant difference existed between pre- and post-insertion pulse rate or blood pressure measures. A significant difference in SaO(2) values was present (p = 0.007). Median ETCO(2) for the study sample was 40 mmHg (interquartile range [IQR] = 33-46 mmHg). Seventy-three percent (8/11) of patients had a time interval of succinylcholine administration to first ventilation of 1 minute or less (range = 1-3 minutes). One case of aspiration was noted on hospital chart review.


CONCLUSIONS
In this case series, paramedics were able to successfully place and use the King LTS-D in patients meeting our emergency medical services (EMS) system indications for RSI.
Frascone
Ralph J
RJ
Regions Hospital Emergency Medical Services, St. Paul, Minnesota, USA. joshua.g.salzman@healthpartners.com
Wewerka
Sandi S
SS
Griffith
Kent R
KR
Salzman
Joshua G
JG
D000328:Adult; D004634:Emergency Medical Technicians; D004867:Equipment Design; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008875:Middle Aged; D008910:Minnesota; D013647:Task Performance and Analysis; D014922:Wisconsin