title: Supraglottic airway device use as a primary airway during rapid sequence intubation.
abstract: BACKGROUND
  This study compared first-attempt placement success rates of the King LTS-D as a primary airway for patients requiring medication-assisted airway management (MAAM) against historical controls.
  
  
  METHODS
  Rotor-wing division of a single critical care transportation company
  
  
  METHODS
  53 providers (RNs/EMT-P) consented to participation and were trained in the use of the King LTS-D. All patients in need of MAAM per agency treatment guidelines were screened for inclusion and exclusion criteria. After each placement attempt, providers completed data collection via telephone. The primary endpoint was comparison of first-attempt placement success rate between the King LTS-D and historical control endotracheal intubation (ETI) MAAM patients. Overall placement success, time to placement, pre- and post-placement SaO2, ETCO2 at 2 minutes after placement, and complications were also analyzed.
  
  
  RESULTS
  38 patients received rapid sequence intubation with the King LTS-D by 23 of 58 consented providers. First-attempt success rate was 76% (29/38), with an overall success rate of 84% (32/38). The primary endpoint analysis showed no difference in first-attempt success rate between historical control ETI MAAM data and King LTS-D (71% vs 76%; OR = 0.1.34 [95% CI Intubation time to insertion was 26 seconds (IQR = 12-46). Pre- and post-insertion SaO(1)2 values were 88.9 ± 12.6% and 92.1 ± 12.7%, respectively. Mean ETCO2 at 2 minutes after placement was 34.8 ± 4.0. Vomit in the patient's airway was the most frequently reported complication (46%).
  
  
  CONCLUSIONS
  Success rates with the King LTS-D were not significantly different from historical control ETI data. Time to placement was comparable to previous reports.
authors: Regions Hospital EMS, St Paul, MN, USA.
authors: Ralph J
authors: RJ
authors: Frascone
authors: Sandi S
authors: SS
authors: Wewerka
authors: Aaron M
authors: AM
authors: Burnett
authors: Kent R
authors: KR
authors: Griffith
authors: Joshua G
authors: JG
authors: Salzman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017732:Air Ambulances; D058109:Airway Management / Q000295:instrumentation* / Q000379:methods; D000488:Allied Health Personnel; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008348:Manikins; D008875:Middle Aged; D009726:Nurses; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D061665:Time-to-Treatment; D000078329:Workforce; D055815:Young Adult