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EFFECTIVENESS AND SAFETY OF LARYNGEAL MASK AIRWAY IN EMERGENCY AIRWAY MANAGEMENT OUT OF THE HOSPITAL
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Abstract
Background: Tracheal intubation is a time- and skill-required maneuver, while bag-valve mask ventilation is only temporary and unreliable. In prehospital settings, laryngeal mask airway (LMA) may be a suitable alternative. Purposes: To evaluate the efficacy and safety of the Supreme and Proseal LMAs for out-of-hospital airway control. Patients and Methods: A prospective and descriptive study was carried out at the Hanoi 115 Emergency Center. Thirty-two emergency patients required for airway control outside of the hospital were included. The paramedics had a two-day course of training about LMAs. The endpoints included the number of attempts and time for LMA insertion, success rate, degree of difficulty, ventilation efficacy, and adverse events recorded. Results: The LMAs were successfully applied to all patients who required airway control (23 Supreme, 9 Proseal). The incidence of successful insertion on the first and second attempts was 87.5% and 12.5%, respectively. The mean time of insertion was 19.7 ± 8.9 seconds. After 3 and 5 minutes of LMA insertion and ventilation, there was a noticeable improvement in oxygen saturation, cyanosis, and Glasgow score. The LMA insertions were considered easy (83.3%) and moderate (16.7%) by paramedics. No adverse events were observed. Conclusions: Supreme and Proseal LMAs provided rapid, effective, and safe airway control outside of hospital settings.
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Keywords
Supreme LMA, Proseal LMA, airway management, out-of-hospital emergency
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