EMERGENCY CASEBOOK
Out-of-hospital use of intubating laryngeal mask airway for difficult intubation caused by cervical dislocation
1 Prehospital Emergency Department (AP-HP), Créteil, France
2 SAMU 94, CHU H Mondor (AP-HP), 94000 Créteil, France
3 Department of Anesthesia, Intensive Care and Prehospital Emergency Medicine, (AP-HP), Créteil, France
Correspondence to:
Correspondence to:
Dr X Combes
Service d’anesthésie réanimation, Hôpital Henri-Mondor, 51 avenue du Maréchal de Lattre-de-Tassigny, 94100 Créteil cedex, France; xavier.combes@hmn.ap-hop-paris.fr
Accepted 13 December 2006
Abbreviations: ILMA, intubating laryngeal mask airway
| The first 150 words of the full text of this article appear below. |
The intubating laryngeal mask airway (ILMA) has become a standard tool for difficult airway management in the operating room. Recent reports have outlined interest in its use in the emergency department setting.1 To date, there are few reports of out-of-hospital ILMA use.2 We describe here an out-of-hospital case of difficult airway, in the context of major cervical trauma, successfully managed with the ILMA.
A mobile medical intensive care unit was called to the scene of a motorcycle accident. The motorcycle driver had been hit by a car at high velocity. The patient, a 35-year-old man, was ejected 35 m from the point of impact. The basic life-support team that reached the accident scene first found the patient lying on the ground with extreme respiratory distress. Because this progressed rapidly to respiratory arrest, a facial bag mask ventilation was initiated, but with major difficulties in obtaining an adequate seal. On arrival
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