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The laryngeal tube device: a simple and timely adjunct to airway management.
Am J Emerg Med. 2007 Mar; 25(3):263-7.AJ

Abstract

INTRODUCTION

Endotracheal intubation (ETI) is a motor skill that demands practice. Emergency medical service providers with limited intubation experience should consider using airway adjuncts other than ETI for respiratory compromise. Prehospital ETI has been recently interrogated by evidence exposing worsened patient outcomes. The laryngeal tube (LT) airway was approved by the Food and Drug Administration in 2003 for use in the United States. Using difficult airway-simulated models, we sought to describe the time difference between placing the ETI and LT and the successful placement of each adjunct in varied levels of healthcare providers.

METHODS

Emergency medicine resident physicians, fourth year medical students, and paramedic students were asked to use both ETI and the LT. Subjects were timed (seconds) on ETI and LT placement on 2 different simulators (AirMan and SimMan; Laerdal Co, Wappingers Falls, NY). After ETI was complete, they were given 30 seconds to review an instructional card before placement of the LT. We measured placement time and successful placement of the device for ETI vs LT. Successful placement in the manikin was defined by a combination of breath sounds, chest rise, and absence of epigastric sounds.

RESULTS

Overall mean placement time in the AirMan and SimMan for ETI was 76.4 (95% confidence interval [CI], 63.3-89.5) and 45.9 (95% CI, 41.0-50.2) seconds, respectively. Mean placement time for the LT in the AirMan and SimMan was 26.9 (95% CI, 24.3-29.5) and 20.3 (95% CI, 18.1-22.5) seconds, respectively. The time difference between ETI and LT for both simulators was significant (P < .0001). Successful placement of the LT compared with ETI in the AirMan was significant (P = .001).

CONCLUSIONS

A significant time difference and simplicity exists in placing the LT, making it an attractive device for expeditious airway management. Further studies will need to validate the LT effectiveness in ventilation and oxygenation; however, its uncomplicated design allows for successful use by a variety of healthcare providers.

Authors+Show Affiliations

Department of Emergency Medicine, University of Iowa, Iowa City, IA 52242, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17349898

Citation

Russi, Christopher S., et al. "The Laryngeal Tube Device: a Simple and Timely Adjunct to Airway Management." The American Journal of Emergency Medicine, vol. 25, no. 3, 2007, pp. 263-7.
Russi CS, Wilcox CL, House HR. The laryngeal tube device: a simple and timely adjunct to airway management. Am J Emerg Med. 2007;25(3):263-7.
Russi, C. S., Wilcox, C. L., & House, H. R. (2007). The laryngeal tube device: a simple and timely adjunct to airway management. The American Journal of Emergency Medicine, 25(3), 263-7.
Russi CS, Wilcox CL, House HR. The Laryngeal Tube Device: a Simple and Timely Adjunct to Airway Management. Am J Emerg Med. 2007;25(3):263-7. PubMed PMID: 17349898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The laryngeal tube device: a simple and timely adjunct to airway management. AU - Russi,Christopher S, AU - Wilcox,Cari L, AU - House,Hans R, PY - 2005/12/02/received PY - 2006/03/17/revised PY - 2006/03/18/accepted PY - 2007/3/14/pubmed PY - 2007/4/20/medline PY - 2007/3/14/entrez SP - 263 EP - 7 JF - The American journal of emergency medicine JO - Am J Emerg Med VL - 25 IS - 3 N2 - INTRODUCTION: Endotracheal intubation (ETI) is a motor skill that demands practice. Emergency medical service providers with limited intubation experience should consider using airway adjuncts other than ETI for respiratory compromise. Prehospital ETI has been recently interrogated by evidence exposing worsened patient outcomes. The laryngeal tube (LT) airway was approved by the Food and Drug Administration in 2003 for use in the United States. Using difficult airway-simulated models, we sought to describe the time difference between placing the ETI and LT and the successful placement of each adjunct in varied levels of healthcare providers. METHODS: Emergency medicine resident physicians, fourth year medical students, and paramedic students were asked to use both ETI and the LT. Subjects were timed (seconds) on ETI and LT placement on 2 different simulators (AirMan and SimMan; Laerdal Co, Wappingers Falls, NY). After ETI was complete, they were given 30 seconds to review an instructional card before placement of the LT. We measured placement time and successful placement of the device for ETI vs LT. Successful placement in the manikin was defined by a combination of breath sounds, chest rise, and absence of epigastric sounds. RESULTS: Overall mean placement time in the AirMan and SimMan for ETI was 76.4 (95% confidence interval [CI], 63.3-89.5) and 45.9 (95% CI, 41.0-50.2) seconds, respectively. Mean placement time for the LT in the AirMan and SimMan was 26.9 (95% CI, 24.3-29.5) and 20.3 (95% CI, 18.1-22.5) seconds, respectively. The time difference between ETI and LT for both simulators was significant (P < .0001). Successful placement of the LT compared with ETI in the AirMan was significant (P = .001). CONCLUSIONS: A significant time difference and simplicity exists in placing the LT, making it an attractive device for expeditious airway management. Further studies will need to validate the LT effectiveness in ventilation and oxygenation; however, its uncomplicated design allows for successful use by a variety of healthcare providers. SN - 0735-6757 UR - https://www.unboundmedicine.com/medline/citation/17349898/The_laryngeal_tube_device:_a_simple_and_timely_adjunct_to_airway_management_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-6757(06)00105-7 DB - PRIME DP - Unbound Medicine ER -