A comparison of two airway aids for emergency use by unskilled personnel. The Combitube and laryngeal mask

Abstract

Many non-anaesthetists find airway control and intubation difficult. The laryngeal mask has been advocated for use by non-anaesthetists at cardiorespiratory arrests, whilst the Combitube is said to provide protection from aspiration. We wished to determine which device was easiest for unskilled staff to use. Staff not previously trained in airway support were briefly taught insertion of each device. Twenty-six ASA 1 or 2 adults, requiring muscle relaxation and tracheal intubation for surgery, were recruited to this randomised crossover study. Both devices were inserted in random order and the time to successful ventilation of the lungs recorded. Both devices were successfully placed in 24/26 patients. The median times to insertion were 40 s and 45 s for the laryngeal mask and Combitube, respectively, with two failures, both with the Combitube (p > 0.05); these were due to faulty operator technique. The Combitube may be a suitable alternative to the laryngeal mask for use in resuscitation by unskilled staff.