Tracheal intubation and alternative airway management devices used by healthcare professionals with different level of pre-existing skills: A manikin study

Abstract

The classic Laryngeal Mask Airway (cLMA™), ProSeal Laryngeal Mask Airway (PLMA™), Intubating Laryngeal Mask Airway™ (ILMA™), Combitube (CT™), Laryngeal Tube (LT™) and tracheal intubation (TI) were compared in a manikin study. Nurses, anaesthetic nurses, paramedics, physicians and anaesthetists inserted the devices three times in a randomised sequence. Time taken for successful insertion, success rates and ease of insertion were evaluated. Anaesthetists performed tracheal intubation significantly faster than other healthcare professionals (p < 0.05). Insertion times for the cLMA, PLMA, LT and CT were not significantly different between the groups. Insertion of the CT, ILMA and TI was associated with a significant learning effect in all groups. This was not observed with the cLMA, PLMA or LT. All non-anaesthetists were able to insert the cLMA, PLMA and LT within two attempts with a > 90% success rate on the first attempt. The ILMA and TI were the only devices where more than one subject experienced some difficulty in insertion. The cLMA, PLMA and LT should be evaluated for use in situations where only limited airway training is possible. © 2009 The Authors.