Comparison of different airway management strategies to ventilate apneic, nonpreoxygenated patients

Abstract

Paramedics were able to employ the laryngeal mask airway, Combitube, and cuffed oropharyngeal airway in apneic patients with normal lung compliance and airways. In this population, bag-valve-mask ventilation was the most simple and successful strategy. Small tidal volumes applied with a pediatric self-inflating bag and 100% oxygen resulted in adequate oxygenation and ventilation.

Part 8: Adult Advanced Cardiovascular Life Support

“…The advantages of the esophageal-tracheal tube over the endotracheal tube are related chiefly to ease of training. 12,43 Ventilation and oxygenation with the esophageal-tracheal tube compare favorably with those achieved with the endotracheal tube. 44 In several controlled clinical trials involving both inhospital and out-of-hospital resuscitation of adults, providers with all levels of experience were able to insert the esophageal-tracheal tube and deliver ventilation comparable to that achieved with endotracheal intubation.…”

“…12,39,44,55,[62][63][64][65] After successful insertion, a small proportion of patients cannot be ventilated with the laryngeal mask airway. 12,44,55 With this in mind, it is important for providers to have an alternative strategy for airway management. Providers who insert the laryngeal mask airway should receive adequate initial training and then should practice insertion of the device regularly.…”

“…All healthcare providers should be familiar with the use of the bag-mask device. 11,12 Use of bag-mask ventilation is not recommended for a lone provider. When ventilations are performed by a lone provider, mouth-to-mouth or mouth-to-mask are more efficient.…”

“…When prehospital providers are trained in the use of advanced supraglottic airways such as the esophageal-tracheal tube, laryngeal tube, and the laryngeal mask airway, they appear to be able to use these devices safely and can provide ventilation that is as effective as that provided with a bag and mask or an endotracheal tube. 12,[35][36][37][38][39][40][41] Advanced airway interventions are technically complicated. Failure can occur; thus maintenance of skills through frequent experience or practice is essential.…”

Comparison of Arterial Blood Gases of Laryngeal Mask Airway and Bag-Valve-Mask Ventilation in Out-of-Hospital Cardiac Arrests

“…quency or time of replacement), 3,4,8,[10][11][12][13][14][15][16][17][18][19][20]26 (2) 11 The present study demonstrated the current status of LMA and BVM with regard to ABG in cases of out-of-hospital cardiac arrest. Although there are a few reports comparing blood gas data during CPR with LMA and BVM, this is the first to show the data of "out-of hospital" cardiac arrests with "VF/VT" on initial ECG at the scene as classified by the Utstein template.…”