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Emerg Med J. 2014 Sep;31(9):750-3. doi: 10.1136/emermed-2012-202283. Epub 2013 Jun 15.

Prehospital use in emergency patients of a laryngeal mask airway by ambulance paramedics is a safe and effective alternative for endotracheal intubation.

Author information

1
Research and Development, Regional Ambulance Service Hollands-Midden, Leiden, The Netherlands.
2
Medical Management, Regional Ambulance Service Hollands-Midden, Leiden, The Netherlands.
3
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
4
Department of Epidemiology, Regional Public Health Organisation Hollands Midden, Leiden, The Netherlands.
5
Emergency Department, Leiden University Medical Center, Leiden, The Netherlands.
6
Centre for Human Drug Research, Leiden, The Netherlands.

Abstract

BACKGROUND:

In Dutch ambulance practice, failure or inability to intubate patients with altered oxygenation and/or ventilation leaves bag-valve mask ventilation as the only alternative, which is undesirable for patient outcome. A novel Laryngeal Mask Airway Supreme (LMA-S) device may be a suitable alternative.

AIM:

To evaluate the effectiveness and suitability of the LMA-S for emergency medical services in daily out-of-hospital emergency practice.

METHODS:

After a period of theoretical and practical training of ambulance paramedics in the use of the LMA-S, prospective data were collected on the utilisation of LMA-S in an observational study. Procedures for use were standardised and the evaluation included the number of direct intubation attempts before using LMA-S, attempts required, failure rate and the adequacy of ventilation. Data were analysed taking patient characteristics such as age and indication for ventilatory support into account.

RESULTS:

The LMA-S was used 50 times over a period of 9 months (33 involving cardiorespiratory arrest, 14 primary and three rescue). The LMA-S could be applied successfully in all 50 cases (100%) and was successful in the first attempt in 49 patients (98%). Respiratory parameters showed adequate oxygenation. All paramedics were unanimously positive about the utilisation of LMA-S because of the easiness of the effort of insertion and general use, and emphasised its value as a useful resource for patients in need.

CONCLUSIONS:

Ensuring ventilation support by using LMA-S by paramedics in prehospital emergency practice is safe and effective.

KEYWORDS:

Trauma; airway; paramedics; resuscitation; ventilation, invasive

PMID:
23771898
PMCID:
PMC4145430
DOI:
10.1136/emermed-2012-202283
[Indexed for MEDLINE]
Free PMC Article

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