title: Laryngeal mask, laryngeal tube, and Frova introducer in simulated difficult airway.
abstract: BACKGROUND
  The use of supraglottic devices is rising in the prehospital management of difficult airway; moreover, we think that patients with multiple trauma or cervical instability can take advantage of these devices without opening or retiring the cervical collar.
  
  
  OBJECTIVE
  To compare speed and ease of use between Laryngeal Tube S (LTS) and the Ambu AuraOnce laryngeal mask (LMA).Our second objective was to evaluate changing these devices to an endotracheal tube (ETT) using a Frova introducer.
  
  
  METHODS
  We studied the use of LTS and LMA in an experimental model, represented by a manikin with a rigid cervical collar and a limited mouth opening. This study was carried out in Complutense University of Madrid with 145 2(nd)-year students for the degree in Dentistry who have knowledge of the airway but lack experience in intubation. Number of attempts and time for the device's insertion were measured, as well as time for the exchange maneuver using the Frova introducer.
  
  
  RESULTS
  Insertion of all devices was possible on the first attempt; time for insertion was LTS 12.2 ± 1.28 s and LMA 6.87 ± 0.97 s. Once these devices were inserted, a Frova introducer is used to perform an exchange by an endotracheal tube; all devices could be exchanged on the first attempt, and exchange time was LTS 26.9 ± 1.2 s and LMA 16.79 ± 1.32 s. Results for both time for insertion and exchange of the LMA were significantly lower than those for the LTS (p < 0.001).
  
  
  CONCLUSIONS
  The method used can be considered quick and easy, even for personnel inexperienced in intubation. This exchange maneuver has not been described previously, so we can consider it as a new application of the Frova introducer.
authors.affiliation: Department of Anaesthesiology and Critical Care, Sureste University Hospital, Arganda del Rey, Madrid, Spain; Department of Anaesthesiology, Faculty of Medicine/Odontology, Complutense University of Madrid, Madrid, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Beleña
authors.affiliation: Department of Anaesthesiology, Faculty of Medicine/Odontology, Complutense University of Madrid, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Gasco
authors.affiliation: Community of Madrid Emergency Services (SUMMA 112), Madrid, Spain.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Polo
authors.affiliation: Department of Anaesthesiology, Faculty of Medicine/Odontology, Complutense University of Madrid, Madrid, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Vidal
authors.affiliation: Department of Anaesthesiology and Critical Care, Ramón y Cajal University Hospital, Madrid, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Núñez
authors.affiliation: Department of Anaesthesiology, Faculty of Medicine/Odontology, Complutense University of Madrid, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Timoneda
mesh_terms: D000328:Adult; D004635:Emergency Medicine / Q000379:methods; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation* / Q000379:methods; D017214:Laryngeal Masks; D008297:Male; D016544:Patient Simulation; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation
keywords: laryngeal mask; laryngeal tube suction; simulated difficult airway