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Sat, 16 Mar 2002 21:29:25 -0000

So its OK to use the LM during cardiac arrest after having curry and a beer
but its not safe if you are involved in trauma - I dont think so. Lets apply
some commonsense - just use equipment that you are familiar with. For me
that would be the LM Proseal (familiar, easy to insert, good pharyngeal
seal, ability to vent the oesophagus and a conduit, with the aid of a
fibreoptic scope and Aintree catheter to secure a definitive airway) or
possibly even ILMA.
OK you cant guarantee that the lower airway will be protected against
aspiration but surely its a case of risk v's benefit - what are the risks
and where is the data that the LM is dangerous in trauma patients - Benefits
are obvious.
As for the combitube - use it if you are familiar with it and it works for
you.
I wouldn't stand up in court for either side on this one!

Pete Barrett
----- Original Message -----
From: "Rowley Cottingham" <rowley@rowleys-host.compulink.co.uk>
To: <trauma-list@trauma.org>
Sent: Thursday, March 14, 2002 11:06 AM
Subject: RE: Combitube

> I agree entirely with John Holmes. I have gone on record before as stating
> that I would act for the prosecution in any case where soiling of the
lower
> airway occurred after insertion of a laryngeal mask after trauma. There is
> good evidence that the soiling is no worse in the cardiac arrest situation
> that using BVM (Baskett and Stone) but none that it is anything but
> dangerous in the traumatised patient.
>
> Best wishes,
>
> Rowley Cottingham
> rowley@cix.co.uk
> http://emergencyunit.com
> premier emergency medicine on the web.
>
>
>
> --
> trauma-list : TRAUMA.ORG
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