LMA vs Dual lumen airway

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wildmedik

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How many field EMS services does anyone know of that actually use LMAs in the field as secondary airway or instead of Endotracheal intubation and Why would you? Our Medical Director is not in favor of it since it does not protect airway, but if alot of services have good track records he is willing to look at it.
 
No one around here uses it. They go with the Kings.


Later!

--Coop
 
We use them here. I am not fond of them, but they have good success with them. I think I have convinced them to go to the King LT, for our back up device. Now see how long it takes them to change!!
 
I've placed a few LMAs while doing clinicals in the OR. On our trucks at work though, we carry Kings as our backup to the ETTs.
 
Backup airways:

I the air: LMA's, King LT's, and/or Combitubes depending on the state and crewmember.

On the ground: Combitubes.

King LT's are fancy EOA's. Personally I'm a combi guy.
 
Central NY region uses LMA's, indicated when multiple attempts at endotracheal intubation fail. I have had to use it once with good results. They now have these intubating LMA's out there on the market; I tried one out a few months ago. I've used the combitube and LT King as well...I like them better, but we're stuck with LMA's for now.
 
are the King LTs not BLS devices? We tested out on them. Vary from state to state?
 
gicts said:
are the King LTs not BLS devices? We tested out on them. Vary from state to state?
Click to expand...



Varies by state / Medical Control.

Basics CAN do them in Texas, but most MD's hold off until intermediate / Medic.
 
el Murpharino said:
Central NY region uses LMA's, indicated when multiple attempts at endotracheal intubation fail. I have had to use it once with good results. They now have these intubating LMA's out there on the market; I tried one out a few months ago. I've used the combitube and LT King as well...I like them better, but we're stuck with LMA's for now.
Click to expand...

What's an "intubating LMA"?

That said, my service only carries Kings. We're taught LMAs and Combitubes in class. We are supposed to use them in place of an OPA for long transport times to avoid gastric distension and vomiting, as well as having to shove back the OPA over and over again when it pops out.
 
Linuss said:
Varies by state / Medical Control.

Basics CAN do them in Texas, but most MD's hold off until intermediate / Medic.
Click to expand...
thanks! :)
 
KING LT! KING LT! KING LT!

Then LMA, then combi.


Combi tubs back in the day were an ok alternative to the ET with a difficult airway. With whats on the market nowadays, get rid of the combi. Combi = trash. Burn the combi. :ph34r::ph34r:
 
Airways in the field.

I have used several different types of airways in the field. Of course the stand is use a OPA or NPA first while using a BVM. It has been my experince to use a ET tube next. If unable to intubate, we have the combi-tube, and LMA. I for one do not like the LMA does not protect the airway. The combi-tube is ok. But what I have found to be excellent airway device is the King airway. It is easy to use and every effective.
 
My service just switched over to the King from using the Combi-Tube for a few years. I like the King sooooo much better, and I think that's the general consensus.

I haven't heard of anyone around here using the LMA. Before the Combi-Tube we used the EOA. I think we are placing Kings far more often than we ever used those.
 
LMA vs Dual Lumen

As we were modifying our protocols, we looked at LMAs, and to be honest, I was not impressed. Nothing beats standard intubation. As far as the King airway, we polled our EMT-B's, and the overwhelming majority favor the King over the Combi tube and (shudder) the PTLA.
 
We use the LMA's here in Southern NJ. I am not fond of them but they are nice to have when we are unable to intubate someone. They should have to be used less though now as we are now carrying the buge to help facilitate in the difficult intubations.
 
Intubating LMA: It's a special LMA that has a blade type thing build into it and you can pass and ETT through the LMA and goes into the trachea b/c where the outlet is in relation to the cords.
 
Extraglottic Devices

Regardless of what people are "fond" of it is important to choose and use devices with the highest likliehood of success. To choose these devices whether LMA, Cook ILA, COBRA, AMBU LM, King LT, or Combitube it is important to look at the science behind each one. Each device will perform better in certain classes of patients over another.

Based on ease of use and scientific data for EMS use I would rate the top 3 as follows:

1) King LT
2) LMA or ILMA
3) Combitube

Good discussion.

Fred Ellinger, Jr. NREMT-P
Regional Course Director
The Difficult Airway Course: EMS
www.difficultairway.net
 
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