title: Use of an intubating laryngeal mask airway on out-of-hospital cardiac arrest patients in a developing emergency medical service system.
abstract: OBJECTIVE
  An intubating laryngeal mask airway (ILMA) is an alternative device for airway control, capable of providing effective ventilation in various situations. The purpose of this study is to compare the effects of the ILMA and bag-valve-mask (BVM) ventilation devices on out-of-hospital cardiac arrest (OHCA) patients.
  
  
  METHODS
  An ILMA training course was conducted by emergency medical technicians (EMTs). Before training, OHCA patients had received BVM ventilation; these patients were defined as the BVM group. After training, all EMTs in the area being served were instructed to immediately use an ILMA on OHCA patients when possible; these patients were defined as the ILMA group. Demographics, transport time, first arterial blood gas data, and the short-term outcomes of these two groups were analyzed.
  
  
  RESULTS
  A total of 398 OHCA patients (89 in the BVM group and 309 in the ILMA group) were analyzed. All of the EMTs passed the training course, and ILMAs were used in the emergency settings. The ILMA was applied to each OHCA patient for a longer-than-average field time than the BVM (9.5 vs. 7.8 minutes, p = 0.006). The 24-hour survival rate of the ILMA-treated patients was significantly higher than BVM-treated patients (36.2% vs. 24.7%, p = 0.033).
  
  
  CONCLUSIONS
  Well-trained EMTs were able to insert the ILMA and ventilate OHCA patients properly in prehospital settings, and ILMA-treated OHCA patients had better short-term outcomes than BVM-treated patients.
authors.affiliation: Division of Traumatology, Department of Surgery, National Yang Ming University Hospital, I-Lan, Taiwan.
authors.forename: Li-Chien
authors.initials: LC
authors.lastname: Chien
authors.forename: Hsiang-Chin
authors.initials: HC
authors.lastname: Hsu
authors.forename: Chih-Hao
authors.initials: CH
authors.lastname: Lin
authors.forename: Ching-Fa
authors.initials: CF
authors.lastname: Cheng
authors.forename: Yung-Chuang
authors.initials: YC
authors.lastname: Tung
authors.forename: Hsien-Cheng
authors.initials: HC
authors.lastname: Hung
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Yeh
authors.forename: Ming-Che
authors.initials: MC
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D058109:Airway Management; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians / Q000193:education*; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation / Q000379:methods*; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome