The introduction of the intubating laryngeal mask into paramedic practice

Abstract

Objective: To ascertain key paramedic-reported factors affecting the implementation of the Intubating Laryngeal Mask Airway (ILMA) into paramedic practice with specific focus on educational practices. Methods: A sequenced exploratory descriptive research design incorporating a questionnaire and semi-structured interviews was employed. Quantitative data collected through the questionnaire was analysed using frequency distribution and Chi Square analysis. Qualitative data from both the questionnaire and the interviews was thematically analysed using a coding and cross comparative analysis technique within a conceptual framework based on Roger’s Diffusion of Innovation model. Results: The results show an educational programme, which departed from the traditional in-theatre model of training, can successfully prepare paramedics for using the new ILMA device for advanced airway management (AAM). Paramedics reported the educational program increased their confidence in using the ILMA for tracheal intubation for AAM, and that they achieved tracheal intubation success rates using the ILMA that were similar to those achieved using the laryngoscope. A blended educational approach of manikin and in-service training is required to be effective for improving their confidence and competence in ILMA tracheal intubation. Conclusions: The successful introduction of an innovation such as the ILMA into paramedic practice requires an education program that is blended and supports an effortless and sustainable change to practice. The results show simulation based ILMA tracheal intubation education can increase paramedics’ confidence and competence as a suitable alternative to the laryngoscope for paramedic tracheal intubation.