Abstract P197: Feasibility of Prehospital Pediatric King Laryngeal Tube Use

Abstract

Introduction- Prehospital endotracheal intubation (ETI) may lead to a worse outcome for pediatric patients. We evaluated prehospital use of the pediatric King laryngeal tube (KLT) as an alternative to ETI. Hypothesis - Prehospital providers can successfully place the KLT and ventilate a pediatric simulator in respiratory arrest. Methods - We studied the ability of forty-five (45) paramedics and flight nurses to place the pediatric KLT in a SimBaby manikin. We limited pediatric KLT training to selection of the correct size as the participants already had initial training and experience with the adult KLT. Outcomes included the rate of successful pediatric KLT placement, number of attempts to correctly place the KLT, and time to first ventilation. Subjects were evaluated on airway management using an 11-point skill test. Subjects indicated perceptions and preferences for the pediatric KLT using a 5-point Likert scale. Data were analyzed using descriptive statistics. Results - 96.5% (95%CI: 89.3–100) subjects successfully placed the pediatric KLT. Median number of attempts was one and mean time to placement was 34 seconds (95%CI: 26.4–67.3 sec). 90% of participants successfully completed the skill test and scored a mean score of 78.2% (95%CI: 73.6–82.7). Subjects strongly agreed (5, IQR: 4–5) that their previous training on the adult KLT and using it in the field adequately prepared them to use the pediatric KLT. Subjects agreed (4, IQR: 3–4) that the pediatric KLT was easier to place than a pediatric endotracheal tube; they strongly agreed (5, IQR: 5–5) that they would use the pediatric KLT as an alternative airway. Participants disagreed (2, IQR: 1–5) that they would prefer the pediatric KLT as a primary means of securing pediatric airways. Conclusions -The pediatric KLT was quickly and reliably placed. Providers perceived the pediatric KLT to be easier to use than pediatric ETI in this setting.