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In the current guidelines of the ERC, tracheal intubation has become less important for persons not trained and different supraglottic airway devices are recommended. The present investigation deals with the application of the laryngeal tube (LT) during prehospital resuscitation by paramedics.
The study was observational during a period of 2 years (2007 to 2009). We registered all cardiac arrest situations in which the LT had been applied according to the ERC guidelines 2005. All participants had completed an obligatory course in emergency medicine, but had not been specifically trained in endotracheal intubation; they were therefore designated as unfamiliar in using the endotracheal tube to secure the airway. Primary outcome measures were placement time and successful placement. Study endpoint was the total 'no flow time', which is defined as the time without chest compression in the first period of cardiac arrest.
During the defined period, 53 resuscitation attempts recorded on standardised data sheets were included. The LT was used in 87% of all cardiac arrest situations. Overall, the LT was successfully and significantly faster inserted (about 9.4 seconds) in more than 96% of all cases, on the first attempt. In 99% of all cases, no problems concerning ventilation of the patient were described. During the cardiac arrest simulation, establishing and performing first ventilation took an average of 12.5 seconds with the LT. Use of the LT during cardiac arrest significantly reduced the 'no flow time' about 87.6 seconds.
As an alternative airway device recommended by the ERC, the LT may enable airway control rapidly and effectively. Additionally, by using the LT, a reduced 'no-flow-time' and a better outcome may be possible. LT may be a good alternative airway device for providing and maintaining a patent airway during resuscitation.