Abstract
The Helicopter Emergency Medical Service (HEMS) was dispatched to the scene of an accident (Figure 1). A train had struck a car on the left side, wedging the 54-year-old driver's head between the seat and the train's bumper. The patient was unconscious and breathing spontaneously. There was heavy airway bleeding from severe maxillo-facial injuries and access for tracheal intubation was not possible. The Laryngeal Mask Airway Supreme (LMA-S) was immediately inserted from in front of the patient by the HEMS anaesthesiologist (7 years experience) on the first attempt to manage the patient's airway.
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