SummaryWe studied the LMA Supreme TM in 100 elective, anaesthetised, healthy patients assessing: ease of use, airway quality, anatomical and functional positioning, airway leak and complications. Insertion was successful on first, second or third attempt in 90, nine and one patient respectively. Thirty manipulations were required in 22 patients to achieve a clear airway. Median [interquartile (range)] insertion time was 18 [10-25 (5-120)] s. During ventilation, an expired tidal volume of 7 ml.kgwas achieved in all patients. Median [interquartile (range)] airway leak pressure was 24 [20-28 (13-40)] cmH 2 O. On fibreoptic examination via the device, vocal cords were visible in 83 patients (85%). During maintenance, five patients (5%) required 13 airway manipulations. There was one episode of minor regurgitation, without aspiration. Other complications and patient side-effects were mild and few. The LMA Supreme is easily and rapidly inserted, providing a reliable airway and good airway seal. Further studies are indicated to assess safety and performance compared to other supraglottic airway devices.

The two devices performed equally well in terms of seal pressure. The PLMA was quicker to insert. Efficacy of ventilation was significantly better with the PLMA than the LT. The PLMA allowed a significantly better view of the larynx with a fibre-optic laryngoscope, and may therefore be of more use in cases where visualization of the larynx is required.

SummaryWe studied the i-gel TM

No abstract

In 2011, a fire broke out on our intensive care unit. An oxygen cylinder caught fire as it was turned on and spread to the mattress of the bed on which it was laid, the bedding, the patient on the bed, the curtains around the bed, the flooring beneath it and the ceiling above. The patient was dragged to safety and the fire put out by two doctors using five fire extinguishers. The unit was filled with smoke within seconds. Ten other patients on the ICU at the time were evacuated within seven minutes, and a patient in a side room (who was not immediately affected) 30 minutes later. We discuss the event, the evacuation, how the aftermath of the fire was managed by the hospital staff, and the changes put in place to improve fire safety locally and nationally.