Clinical paperOut-of-hospital airway management by paramedics and emergency physicians using laryngeal tubes☆,☆☆
Section snippets
Material and methods
During a 24-month period, a cohort study was performed, during which all prehospital intubations with either the laryngeal tube disposable or the laryngeal tube suction disposable (LT-D and LTS-D, VBM Medizintechnik GmbH, Sulz a.N., Germany) performed by paramedics and emergency physicians were recorded by means of a standardised questionnaire, which was approved by the institutional review board. The operational areas of the emergency medical services (EMS) consisted of the German metropolitan
Results
During a 24-month period, 155 adults (mean age 60 ± 17 years, mean body mass index 30 ± 6 kg m−2) and two children aged 9 months and 7 years underwent emergency management airway with either the LT-D (n = 19) or the LTS-D (n = 138). According to the manufacturer's instructions for use, the LT-D/LTS-D sizes used were size 5 (n = 96), size 4 (n = 58), size 3 (n = 2) and size 0 (n = 1). The indications for airway management are shown in Table 2.
Compared with paramedics, who used the LT-D/LTS-D significantly more
Discussion
The results of our study show that the LT-D/LTS-D was effective in managing the airway in out-of-hospital environments by both emergency physicians and paramedics. In 94.3% of the cases, the laryngeal tube could be placed within two attempts. In only five out of 157 patients, laryngeal tube placement failed, and the patients underwent either endotracheal intubation or cricothyrotomy. Establishing an airway failed completely in only one out of 157 patients (0.6%), in whom bag-valve-mask
Conflict of interest
None of the authors has any conflict of interest with devices and/or companies mentioned in the article or with potentially competing devices and/or companies.
Acknowledgement
The authors would like to thank all paramedics and emergency physicians of the participating emergency medical services for their efforts and support during this study. Our particular thanks are due to: Ralf Peter Feuster, MD, Jennifer Fries, RN, Rolf Kirchner, MD, Dirk Meininger, MD, Norman Peter, RN, Bertram Scheller, MD, and Elvira Wenzel, RN, Clinic of Anaesthesiology, Intensive Care Medicine, and Pain Therapy, University of Frankfurt, Germany; Kai Rüttger, MD and Sophie Wetzel, MD,
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Cited by (0)
- ☆
A Spanish translated version of the abstract of this article appears as Appendix in the final online version at doi:10.1016/j.resuscitation.2009.11.007.
- ☆☆
The study was presented in part during the Annual Meeting of the German Society of Anaesthesiologists, Leipzig, Germany, 11 May 2009.
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These authors contributed equally to the study.