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Association: Name: National Association of EMS Physicians URL: http://www.naemsp.org
Citation: URL: http://www.allacademic.com/meta/p66726_index.html Direct Link: HTML Code:

Silvestri, Salvatore., Ralls, George. and Ho, Alex. "Prehospital Laryngeal Mask Airway Use by Emergency Medical Technician-Basics" Paper presented at the annual meeting of the National Association of EMS Physicians, Registry Resort, Naples, FL, <Not Available>. 2009-05-25 <http://www.allacademic.com/meta/p66726_index.html>

Silvestri, S. , Ralls, G. and Ho, A. "Prehospital Laryngeal Mask Airway Use by Emergency Medical Technician-Basics" Paper presented at the annual meeting of the National Association of EMS Physicians, Registry Resort, Naples, FL <Not Available>. 2009-05-25 from http://www.allacademic.com/meta/p66726_index.html

Publication Type: Abstract Abstract: Objective: To evaluate the prehospital use of Laryngeal Mask Airways (LMAs) by Emergency Medical Technician-Basics (EMT-Bs). Methods: The study setting is a large, urban, single and two-tiered EMS system that performs approximately 65,000 patient responses per year. This study is a retrospective review of patients with prehospital respiratory failure managed with an LMA placed by an EMT-B. The EMS system-reporting database was queried for all cases where an LMA was placed by an EMT-B for the study period (December 2002 to September 2004). Patient Care reports of patients meeting the inclusion criteria were reviewed and data was extracted. Prior to the study period, EMT-Bs underwent a didactic and practical (i.e. mannequin simulation) training program on prehospital LMA use. EMT-Bs were trained to identify correct LMA placement by their ability to insert the device, maintain a seal, and provide effective ventilation. Successful LMA placement was determined by EMT-B self-reporting based upon the above criteria covered during training. Results: During the study period, there were approximately 30,000 patient transports and 700 cardiac arrests. 49 cases were identified who met inclusion criteria for the 22-month study period. The mean age of the study group was 57.4 (± 18.6), with 32 males, and 10 cases were trauma. Of the 49 study group patients, 43 were in cardiac arrest. Two size 3, twelve size 4, and 35 size 5 LMAs were placed. The success rate for LMA placement was 71%. Reasons for unsuccessful placement included inability to stabilize the LMA (2 cases), inability to maintain a seal (3 cases), and the remaining nine cases of failed placement did not cite a specific reason. Conclusion: Within this EMS system, EMT-Bs demonstrated successful prehospital LMA use comparable to published prehospital studies of other providers. Future randomized controlled trials will help identify the specific components of LMA use associated with unsuccessful ventilation, will help elucidate the prehospital role of LMAs, and will help standardize uniform reporting guidelines.

Good work: Emergency medical technicians in the public and private sectors

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