A 12-month audit of laryngeal mask airway (LMA) use in a South Australian ambulance service

Abstract

The aim of the study was to provide an accurate account of current practice of laryngeal mask airway (LMA) use within SA Ambulance Service (SAAS) and identify issues that could lead to constructive training for paramedics and improve clinical care and patient safety. A clinical audit of LMA use within SAAS was registered with the Director of Clinical Governance at Flinders Medical Centre in South Australia. Data were collected prospectively in a state wide all inclusive study over 12 months (February 2006 to January 2007). The primary outcome variable we determined was successful insertion after one or two attempts. Secondary outcome measures were overall success rate and reasons for failure. Insertion of an LMA was attempted by 179 paramedical staff in 164 patients. Success after one or two attempts was obtained in 65% of patients (107/164). Overall success rate (any number of attempts) was 74% (121/164), of those 45% were on the first attempt, 20% on the second attempt and the remainder (9%) required three or more attempts to achieve successful insertion. Reported failures were ascribed to patient anatomy (13), technique (9), airway soiling (7), device (6), trismus (1), high Glasgow Coma Score (1), trauma (1) or unknown (5). This clinical audit provides a comprehensive account of LMA use within SA Ambulance Service. Although the current practice was found to be acceptable, these results are below those of comparable groups and should be improved upon.