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Emergency Airway Placement by EMS Providers: Comparison between the King LT Supralaryngeal Airway and Endotracheal Intubation

Abstract Introduction: The ever-present risk of mass casualties and disaster situations may result in airway management situations that overwhelm local emergency medical services (EMS) resources. Endotracheal intubation requires significant user education/training and carries the risk of malposition. Furthermore, personal protective equipment (PPE) required in hazardous environments may decrease dexterity and hinder timely airway placement. Alternative airway devices may be beneficial in these situations. Objective: The objective of this study was to evaluate the time needed to place the King LT Supralaryngeal Airway compared to endotracheal intubation when performed by community EMS personnel with and without PPE. Methods: Following training, 47 EMS personnel were timed placing both endotracheal tubes and the King LT supralaryngeal airway in a simulator mannikin. The study participants then repeated this exercise wearing PPE. Results: The EMS personnel wearing PPE took significantly longer to place an endotracheal tube than they did without protective equipment (53.4 seconds and 39.5 seconds, p <0.002). The time to place the King LT was significantly faster than the placement of the endotracheal tube without protective equipment (18.4 seconds and 39.5 seconds, respectively, p<0.00003). There also were statistically significant differences between the time required to place the King LT and endotracheal tube in EMS personnel wearing protective equipment (19.7 seconds and 53.4 seconds, p <0.000007). Conclusions: The King LT Supralaryngeal Airway device may be advantageous in prehospital airway management situations involving multiple patients or hazardous environments. In this study, its insertion was faster than endotracheal intubation when performed by community EMS providers.