爱荷华州农村紧急医疗服务系统中使用King LT喉上气道的初步研究。

A pilot study of the King LT supralaryngeal airway use in a rural Iowa EMS system.

作者信息

Russi Christopher S, Hartley Michael J, Buresh Christopher T

机构信息

Department of Emergency Medicine, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

Int J Emerg Med. 2008 Jun;1(2):135-8. doi: 10.1007/s12245-008-0023-5. Epub 2008 Jun 12.

DOI:10.1007/s12245-008-0023-5

PMID:19384666

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2657251/

Abstract

INTRODUCTION

In 2003, the King Laryngeal Tube (LT) received FDA approval for US sales. Prehospital systems in urban setting have begun evaluating and adopting the LT for clinical airway management. However, it is not routinely approved by State EMS Boards for use by all prehospital providers. Given the LT's simple design there may be benefit to using this tool for airway management in all levels of prehospital providers. This pilot study reviews cases where the King LT was used in a rural Iowa county EMS system.

METHODS

In 2006, the Iowa Department of Public Health / Bureau of EMS approved a 12 month pilot evaluating the King LT by all levels of EMS providers in a rural county EMS system. Following a didactic and competency training session on using the King LT, the providers were instructed to continue airway management per usual protocol but were allowed to use the King LT as a first line airway tool if they felt indicated. Successful placement of airway devices used were determined by colourimetric end-tidal CO2, chest auscultation and rise as well as vital sign and skin colour improvement. Review of the data was approved by the University of Iowa Institution Review Board (IRB).

RESULTS

During the 12-month pilot period, the King LT was used in 13 patients with a mean age of 60.7 years (24-81). All patients had cardiopulmonary or traumatic arrest. The King LT was successfully placed on the first attempt in all but one case. The King LT was placed following endotracheal intubation failure in 6/13 (46.1%) cases and in 3/13 (23.1%) of cases of Combitube attempt / failure.

CONCLUSIONS

This small pilot project emphasizes the need for additional rapid airway management tools given the demonstrated ETI failures. The authors believe the King LT has significant potential to impact prehospital airway management as a primary airway device or backup to other failed strategies. Further study is necessary to evaluate the LT's efficacy compared to current strategies.

摘要

引言

2003年，King喉管（LT）获得美国食品药品监督管理局（FDA）批准在美国销售。城市环境中的院前急救系统已开始评估并采用King喉管进行临床气道管理。然而，它并未得到州紧急医疗服务委员会的常规批准，以供所有院前急救人员使用。鉴于King喉管设计简单，在各级院前急救人员中使用该工具进行气道管理可能会有好处。这项初步研究回顾了爱荷华州一个农村县紧急医疗服务系统中使用King喉管的案例。

方法

2006年，爱荷华州公共卫生部/紧急医疗服务局批准了一项为期12个月的试点项目，由一个农村县紧急医疗服务系统的各级紧急医疗服务人员对King喉管进行评估。在进行了关于使用King喉管的理论和技能培训课程后，急救人员被指示按照常规方案继续进行气道管理，但如果他们认为有必要，可以将King喉管作为一线气道工具使用。使用的气道装置是否成功放置通过比色法呼气末二氧化碳监测、胸部听诊及胸廓起伏以及生命体征和皮肤颜色改善来确定。对数据的审查获得了爱荷华大学机构审查委员会（IRB）的批准。

结果

在为期12个月的试点期间，King喉管被用于13例患者，平均年龄为60.7岁（24 - 81岁）。所有患者均发生心肺骤停或创伤性骤停。除1例病例外，King喉管在所有病例中首次尝试均成功放置。在6/13（46.1%）例气管插管失败后放置了King喉管，在3/13（23.1%）例Combitube尝试/失败的病例中也放置了King喉管。