Therapeutics
The intubating laryngeal-mask airway may be an ideal device for airway control in the rural trauma patient,☆☆,

https://doi.org/10.1053/ajem.2003.50012Get rights and content

Abstract

A review of the literature on advanced airway management indicates that the intubating laryngeal-mask airway (ILMA) may be an ideal device for airway control in the rural trauma patient. The ILMA is an advanced laryngeal-mask airway designed to allow oxygenation of the unconscious patient as well as blind tracheal intubation with an endotracheal tube. The ILMA is an easy-to-use airway with a high success rate of insertion, and requires little training. For the rural physician managing a difficult airway in a trauma patient, the ILMA has been found to be reliable and successful when other techniques fail, such as fiberoptic intubation and direct laryngoscopy. The ILMA has also been reported to cause less hemodynamic change and less injury to the teeth and lips than direct laryngoscopy. Further, the ILMA was found to be easier and faster to use with a higher success rate than either the combitube or endotracheal tube for unskilled healthcare providers. Limitations and complications of the ILMA may include aspiration, esophageal intubation, damage to the larynx or other tissues during blind passage of a tracheal tube, and edema of the epiglottis. (Am J Emerg Med 2003;21:80-85. Copyright 2003, Elsevier Science (USA). All rights reserved.)

Section snippets

Background

The laryngeal mask airway (LMA) was first described in 1983 by Brain, and has been commercially available in the United Kingdom since 1988.6 In the years since its introduction, the LMA has gained wide acceptance throughout Europe and the United States. The LMA is a mask that fits over the larynx, in a way similar to the way in which a face-mask fits over the face. It is oval, with an inflatable balloon surrounding its periphery and a tube that serves as a conduit between the mask and the

Conclusion

The care given during the “golden hour” after trauma is the most crucial determinant of eventual outcome.17 Patient management during this critical period often lies in the hands of paramedical personnel or rural emergency physicians. The primary goal in resuscitation is to establish a patent airway to allow adequate oxygenation, yet prevent pulmonary aspiration of blood and vomitus. Difficulty arises in that the trauma patient who presents to a rural ED with the need for establishment of an

Acknowledgements

The author thanks Dr Matt Layman, MDA, of the Anesthesia Department of Regions Hospital, for his time and commitment in advising on writing this manuscript.

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  • Cited by (0)

    Manuscript returned August 1, 2001.

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