The Usefulness of Laryngeal Tube in Airway Maintenance and Intermittent Positive Pressure Ventilation for Paramedics

Abstract

Background: Supraglottic airway devices (SADs) are used to keep the upper airway open and to provide unobstructed ventilation. The recent addition to SADs is the laryngeal tube (LT). It can be inserted blindly past the oropharynx into the hypopharynx to provide a patent airway and mechanical ventilation during emergency conditions and cardiopulmonary resuscitation. Aim: To evaluate the success rate and usefulness of LT insertion for airway maintenance and intermittent positive pressure ventilation on manikins by paramedical personnel. Methods: The technique of LT insertion was explained to 200 paramedical personnel, all of whom attempted its insertion three times; the maximum time allowed for 3 attempts was 3 min. The success rate in terms of ease of insertion, adequacy of ventilation and the audible leak was assessed. The average time taken for insertion and success rate in the first, second and third attempts was assessed. Confirmation was done by ventilation with a self-inflating bag and adequate lung inflation. Results: Average time taken for insertion of LT was 14.66 ± 4.96 s. With progressive attempts, the success rate improved to 86.5%, adequacy of ventilation to 96.5% and only a minimal leak was appreciated in all. Conclusion: The LT could be a reliable device for airway management in emergencies by paramedical personnel as all participants successfully placed it within three attempts with a very good success rate.