Laypersons can successfully place supraglottic airways with 3 minutes of training. A comparison of four different devices in the manikin.
BACKGROUND
Supraglottic airway devices have frequently been shown to facilitate airway management and are implemented in the ILCOR resuscitation algorithm. Limited data exists concerning laypersons without any medical or paramedical background. We hypothesized that even laymen would be able to operate supraglottic airway devices after a brief training session.


METHODS
Four different supraglottic airway devices: Laryngeal Mask Classic (LMA), Laryngeal Tube (LT), Intubating Laryngeal Mask (FT) and CobraPLA (Cobra) were tested in 141 volunteers recruited in a technical university cafeteria and in a shopping mall. All volunteers received a brief standardized training session. Primary endpoint was the time required to definitive insertion. In a short questionnaire applicants were asked to assess the devices and to answer some general questions about BLS.


RESULTS
The longest time to insertion was observed for Cobra (31.9 ± 27.9 s, range: 9-120, p < 0.0001; all means ± standard deviation). There was no significant difference between the insertion times of the other three devices. Fewest insertion attempts were needed for the FT (1.07 ± 0.26), followed by the LMA (1.23 ± 0.52, p > 0.05), the LT (1.36 ± 0.61, p < 0.05) and the Cobra (1.45 ± 0.7, p < 0.0001). Ventilation was achieved on the first attempt significantly more often with the FT (p < 0.001) compared to the other devices. Nearly 90% of the participants were in favor of implementing supraglottic airway devices in first aid algorithms and classes.


CONCLUSIONS
Laypersons are able to operate supraglottic airway devices in manikin with minimal instruction. Ventilation was achieved with all devices tested after a reasonable time and with a high success rate of > 95%. The use of supraglottic airway devices in first aid and BLS algorithms should be considered.
Department of Anesthesiology, University Hospital Aachen, Aachen, Germany. gschaelte@ukaachen.de
Gereon
G
Schälte
Christian
C
Stoppe
Meral
M
Aktas
Mark
M
Coburn
Steffen
S
Rex
Marlon
M
Schwarz
Rolf
R
Rossaint
Norbert
N
Zoremba
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D005392:First Aid; D006801:Humans; D007442:Intubation, Intratracheal; D017214:Laryngeal Masks; D008297:Male; D008348:Manikins; D008875:Middle Aged; D013997:Time Factors; D014838:Volunteers