Laryngeal Mask Airway and Tracheal Tube Insertion by Unskilled Personnel

Training in airway management

“…Studies show that the learning curve for placement of the laryngeal mask airway is very steep. In one study, a 94% success rate was achieved on the first insertion [55], and in others a > 90% success rate was achieved by the second [54] or third attempt [52,53]. This is in contrast to the bag and facemask, which in one study had a success rate of < 50% after 10 attempts [52].…”

“…Even following such brief training, success rates for insertion of and ventilation with the laryngeal mask airway were 87%, compared with 43% for ventilation with the bag and facemask alone [52]. Other studies have shown similarly high success rates for inserting the laryngeal mask airway after very little training [53][54][55]. In one study, following only brief instructions and no practice, 94% of paramedics were successful on the first attempt [55].…”

“…The learning process for tracheal intubation has also been studied, with a wide variety of results. Small studies of medical students have suggested a rapid improvement of skills following a short training programme: one study found that 93% of students performed intubation correctly on their third attempt [108]; another showed an 80% success rate by the tenth attempt [53]. However, a more formally generated learning curve in anaesthetists suggests a 90% success rate after 57 attempts, and even after 80 attempts, 18% of the trainees needed assistance [109].…”

A comparison of two airway aids for emergency use by unskilled personnelThe Combitube and laryngeal mask

“…The laryngeal mask airway has been suggested as an alternative to tracheal intubation during cardiopulmonary resuscitation, particularly when this occurs in an area not immediately serviced by anaesthetists [1][2][3]. The laryngeal mask appears to provide little protection from aspiration [2] although the actual incidence of aspiration is unknown.…”

“…The laryngeal mask appears to provide little protection from aspiration [2] although the actual incidence of aspiration is unknown. The Combitube (Kendall-Sheridan) has been suggested as an alternative to the laryngeal mask which, because of its design, may provide more protection against aspiration [4,5].…”