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Use of the laryngeal tube by paramedics during prehospital resuscitation: an observational study

Introduction

In the current guidelines of the ERC, tracheal intubation has become less important for persons not trained and different supraglottic airway devices are recommended. The present investigation deals with the application of the laryngeal tube (LT) during prehospital resuscitation by paramedics.

Methods

The study was observational during a period of 2 years (2007 to 2009). We registered all cardiac arrest situations in which the LT had been applied according to the ERC guidelines 2005. All participants had completed an obligatory course in emergency medicine, but had not been specifically trained in endotracheal intubation; they were therefore designated as unfamiliar in using the endotracheal tube to secure the airway. Primary outcome measures were placement time and successful placement. Study endpoint was the total 'no flow time', which is defined as the time without chest compression in the first period of cardiac arrest.

Results

During the defined period, 53 resuscitation attempts recorded on standardised data sheets were included. The LT was used in 87% of all cardiac arrest situations. Overall, the LT was successfully and significantly faster inserted (about 9.4 seconds) in more than 96% of all cases, on the first attempt. In 99% of all cases, no problems concerning ventilation of the patient were described. During the cardiac arrest simulation, establishing and performing first ventilation took an average of 12.5 seconds with the LT. Use of the LT during cardiac arrest significantly reduced the 'no flow time' about 87.6 seconds.

Conclusions

As an alternative airway device recommended by the ERC, the LT may enable airway control rapidly and effectively. Additionally, by using the LT, a reduced 'no-flow-time' and a better outcome may be possible. LT may be a good alternative airway device for providing and maintaining a patent airway during resuscitation.

References

  1. 1.

    Wiese CH, et al.: The use of the laryngeal tube disposable (LT-D) by paramedics during out-of-hospital resuscitation-an observational study concerning ERC guidelines 2005. Resuscitation 2009, 80: 194-198. 10.1016/j.resuscitation.2008.08.023

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Correspondence to G Papakitsos.

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Papakitsos, G., Papakitsou, T. & Kapsali, A. Use of the laryngeal tube by paramedics during prehospital resuscitation: an observational study. Crit Care 14, P310 (2010). https://doi.org/10.1186/cc8542

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Keywords

  • Cardiac Arrest
  • Flow Time
  • Tracheal Intubation
  • Endotracheal Intubation
  • Chest Compression