Prehospital Use of the Intubating Laryngeal Mask Airway in Patients with Severe Polytrauma: A Case Series

Abstract

A case series of five patients is described demonstrating the utility of the intubating laryngeal mask airway in the prehospital setting, both as a primary airway rescue device and as a bridge to tracheal intubation. All patients were hypoxaemic, had sustained severe polytrauma and were trapped in their vehicles following road traffic collisions. A probability of survival study showed better-than-predicted outcomes for the group as a whole.

Simulating face-to-face tracheal intubation of a trapped patient: a randomized comparison of the LMA Fastrach™, the GlideScope™, and the Airtraq™ laryngoscope

“…1 Laryngeal mask airways 2 and more particularly the intubating laryngeal mask airway Fastrach TM (LMA Fastrach TM , SEBAC, Pantin, France) have been used in such patients as a primary airway to restore ventilation and to blindly intubate the trachea. 3 However, the success rate for blind tracheal intubation through the LMA Fastrach TM may be lowered by the fact that manoeuvres described to improve tracheal intubation performance cannot be used in patients with suspected or simulated cervical spine injury. 3 4 Interestingly, there has been a report in which an indirect optical laryngoscope proved to be more effective than the Macintosh laryngoscope in intubating the trachea of a simulated patient confined in a driver's seat of a car.…”

Pharmacologically assisted laryngeal mask insertion: a consensus statement

“…The evidence base for the technique is scant, with only a small series of case reports describing the technique. 2 However the role of SADs in both in-hospital and prehospital use, both routine and difEcult, is well established. 3 The prehospital use of SADs has increased with their routine use in the airway management of cardiac arrests.…”

Pharmacologically assisted laryngeal mask insertion: a consensus statement

“…The evidence base for the technique is scant, with only a small series of case reports describing the technique 2. However the role of SADs in both in-hospital and pre-hospital use, both routine and difficult, is well established 3…”