A comparison of the intubating and standard laryngeal mask airways for airway management by inexperienced personnel

Choyce, Andrew; Avidan, Michael S.; Shariff, Amina; Águila, María del Mar Rodríguez-Medel del; Radcliffe, Jeremy; Chan, T.

doi:10.1046/j.1365-2044.2001.01708-3.x

Cited by 38 publications

(18 citation statements)

References 20 publications

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“…However, this technique does not allow the trainee to assess adequacy of ventilation through the device. Insertion of the intubating laryngeal mask airway has been shown to be similarly easy to master with comparable rates of successful insertion by novices [59,60]. Because of the relative ease of learning these techniques, there is little literature on actual methods of training.…”

Section: Live Humansmentioning

confidence: 99%

Training in airway management

2002

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Section: Live Humansmentioning

confidence: 99%

Training in airway management

2002

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“…Previous studies in patients, cadavers and manikin have all proven LMA, FT, LT and Cobra to be efficient tools for airway management in the hands of naïve "intubators" and inexperienced medical personnel [5,6,12-16]. These studies investigated first year medical, paramedical and nursing students, as well as military personnel in combat paramedical or medical education.…”

Section: Discussionmentioning

confidence: 99%

Laypersons can successfully place supraglottic airways with 3 minutes of training. A comparison of four different devices in the manikin

Schälte

Stoppe

Aktaş

et al. 2011

Scand J Trauma Resusc Emerg Med

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IntroductionSupraglottic 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.MethodsFour 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.ResultsThe 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.ConclusionLaypersons 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.

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“…[62][63][64] Using cadavers, Choyce et al demonstrated that non-experienced medical students had significantly faster and greater success at ventilation with the use of FT-LMA compared with a C-LMA. 63 Moreover, 67% of these same untrained medical students were able to successfully intubate the trachea through the FT-LMA.…”

Section: Use By Inexperienced Providers and Nonanesthesiologistsmentioning

confidence: 99%

The FastrachTM Intubating Laryngeal Mask Airway®: an overview and update

Gerstein

Braude

Hung

et al. 2010

Can J Anesth/J Can Anesth

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Purpose To provide an evidence-based overview and update on the use of the Fastrach TM Intubating Laryngeal Mask AirwayÒ (FT-LMA) when used within operative and non-operative settings. Principal findings The FT-LMA is available in three sizes to provide ventilation and the ability to pass an endotracheal tube (ETT) into the trachea blindly, semi-blindly, or with indirect visualization for patients over 30 kg. The Chandy maneuver is recommended routinely; the first maneuver optimizes ventilation, and the second maneuver increases success at endotracheal intubation (ETI). The manufacturer's reinforced tube or a pre-warmed or reversed standard ETT may be utilized. Insertion and ventilation are successful in almost all patients. Blind ETI is highly successful; adjuncts are generally not necessary. The FT-LMA has a proven role in the airway management of anticipated difficult operating room (OR) intubations, unanticipated OR intubations, cervical spine injuries, and limited airway access situations. Literature in the pre-hospital and emergency department settings is limited but favourable. The FT-LMA has compared favourably with fibreoptic intubation, the LMA-Classic TM , the laryngeal tube, and the CobraPLA TM . Initially, the more expensive LMA CTrach TM appeared to be more successful, but overall it is not. The FT-LMA airway seal pressures are excellent; serious complications are uncommon, and the FT-LMA figures prominently in most difficult airway guidelines. Conclusions The FT-LMA has proven to be a useful difficult airway device both within and outside of the operating room. Effective ventilation is established in nearly all cases, and blind ETI is possible in the vast majority of cases if the optimal techniques described are used. Serious complications are uncommon. Constatations principales Le FT-LMA est disponible en trois tailles pour permettre la ventilation et le passage d'une sonde endotrache´ale (SET) dans la trache´e de façon aveugle, semi-aveugle ou avec visualisation directe chez les patients pesant plus de 30 kg. La manoeuvre de Chandy est recommande´e de façon routinie`re; la premie`re manoeuvre optimise la ventilation, et la seconde augmente le succe`s lors d'une intubation endotrache´ale (IET). La sonde arme´e du fabricant ou une SET standard pre´chauffe´e ou inverse´e peut eˆtre utilise´e. L'insertion et la ventilation re´ussissent chez presque tous les patients. L'IET en aveugle a un taux de re´ussite e´leve´; en re`gle ge´ne´rale, les accessoires ne sont pas ne´cessaires. Le FT-LMA joue un rôle e´prouve´dans la prise en charge des voies ae´riennes lors d'intubations anticipe´es comme difficiles dans la salle d'ope´ration (SOP), d'intubations impre´vues en SOP, de le´sions de la colonne cervicale et dans les situations oul 'acce`s aux voies ae´riennes est limite´. La litte´rature portant sur son utilisation dans des contextes pre´-hospitaliers et dans le de´partement des urgences est restreinte mais favorable. Le FT-LMA a e´te´favorablement compare´al 'intubation par fibroscopie, au LMA...

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A comparison of the intubating and standard laryngeal mask airways for airway management by inexperienced personnel

Cited by 38 publications

References 20 publications

Training in airway management

Training in airway management

Laypersons can successfully place supraglottic airways with 3 minutes of training. A comparison of four different devices in the manikin

The FastrachTM Intubating Laryngeal Mask Airway®: an overview and update

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