Esophageal obturator airway, ET tube, and pharyngeal-tracheal lumen airway.

Prior to approval of the EOA, this device had not been documented to be effective in oxygenation and ventilation in the pre-hospital arena. The studies quoted to demonstrate its usefulness were done in the very controlled environment of the operating room or of the emergency department. Indeed, the studies on blood gases obtained immediately upon entry into the emergency department would indicate that the esophageal obturator airway is an inadequate and ineffectual pre-hospital airway. The ability of the device to obstruct the esophagus, has been questioned. In a recent review of the EOA, Smith et al state that "How the EOA gained widespread popularity for use in patients requiring CPR without any evidence of its effectiveness is worthy of investigation". The Food and Drug Administration "grandfathered" the EOA as an acceptable device. This approval was to be reviewed with time, and if complications were reported, a second evaluation of the esophageal obturator airway was to be undertaken. Unfortunately, this has never occurred. We are now faced with the pharyngeal-tracheal lumen airway, which is being marketed for use in the pre-hospital area. The Food and Drug Administration approved the marketing and use of this device based on its similarity to the esophageal obturator airway. The PTL, is a device in many respects similar to the EOA. It has been tested in the operating room and the emergency department. In a study done on unsuccessfully resuscitated patients, it was as effective as an ETT. However, no study has shown that the PTL can be used successfully in the pre-hospital setting by ambulance personnel.(ABSTRACT TRUNCATED AT 250 WORDS)