When To Use King Air/CombiTube/LMA

Zoidberg

Zoidberg

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I'm brand new to the forum first post ever.
I am also New Student slowly trying to figure things out. I would like to know in what real world situations would you use a king air, combi tube, or LMA; Versus OPA/NPA ?
 
Unconscious/unresponsive and apneic without a gag reflex, gets an OPA immediately and bag with that until I can set up the King/Combi/LMA.
Unconsciousunresponsive and apneic with a gag reflex gets an NPA only.
 
OPA is for somebody who has a problem likely to rapidly improve (e.g. GHB overdose) or as an interim measure until you can get an LMA in.def

LMA is best thought of as "hands free bag and mask" for people who need a more definitive airway and where their problem is not going to rapidly improve.

NPA is an alternative when somebody cannot take an OPA.
 
If they need airway control/protection and you don't expect a rapid improvement (i.e. hypoglycemia). With that said if you're close to the hospital and you are able to provide adequate ventilation and oxygenation with a BLS airway there's no reason to escalate.

You're asking a question that there's no correct answer too. It's all going to be patient and situation dependent. I hate the saying "BLS before ALS" because if my patient needs an ALS intervention I'm not going to **** around with BLS ones but you need to take into account where you're at and what's going to benefit the patient. Don't be the person who does skills just because they can.
 
No one mentioned intubation. Is that no longer an option?
 
MackTheKnife said:
No one mentioned intubation. Is that no longer an option?
Click to expand...
I was assuming the OP is in school to be an EMT or is currently an EMT and that intubation is outside of their scope
 
Simply put, I'll use any/all of those methods when my patient needs a patent airway and can't maintain it by themselves. I'll drop an OPA first because I can do it in seconds. That also establishes presence/absence of a gag reflex. If there's a gag reflex, I'll pull out an NPA and use that to help maintain a patent airway. If there's no gag reflex, I'm going to reach for an "advanced" airway and while I would prefer the ETT, I might reach for the LMA if it allows intubation through it, otherwise my backup choice is the King Tube or Combitube and then a non-intubating LMA.
 
This tutorial by Craig Ellis (St John Deputy Medical Director) explains things well

 
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