Paramedics Manage the Airway Easier with Laryngeal Mask Airway Than with Intubation during Simulated CPR Scenarios

Abstract

Objectives. In this study, we investigated whether minimally trained paramedics with no previous experience in securing the airway would be more efficient in placing laryngeal mask airway (LMA) than intubating the trachea with direct laryngoscopy using 2 manikin scenarios: without chest compressions (non-CPR scenario) and with continuous chest compressions (CPR scenario). Methods. One hundred and twenty-four paramedics with no previous experience in managing the airway comprised our study population. Three 20 min lectures on the anatomy of the airway and endotracheal intubation with the Macintosh blade and LMA placement were given. Each participant attempted to insert a LMA or to intubate a manikin with the Macintosh blade using 2 different scenarios: without chest compressions and with continuous chest compressions. Results. All participants managed to place a LMA in both scenarios, but only 85% of them managed to intubate the trachea using the Macintosh blade in the non-CPR and even less than (80%) in the CPR scenario. Insertion of the LMA was statistically significantly faster than intubation with the Macintosh blade in both scenarios (). Conclusions. Our results provide evidence that for minimally trained paramedics, LMA insertion is much faster than endotracheal intubation.