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      Here is some supporting data:

      Prehosp Emerg Care 1997 Jan-Mar;1(1):1-10 =20

The PTL, Combitube, laryngeal mask, and oral airway: a randomized =
prehospital comparative study of ventilatory device effectiveness and =
cost-effectiveness in 470 cases of cardiorespiratory arrest.

Rumball CJ, MacDonald D.

Paramedic Academy, Justice Institute of British Columbia Faculty of =
Medicine, University of British Columbia, Canada.

PURPOSE: A prehospital study was conducted to assess and compare three =
alternative airway devices and the oral airway for use by non-Advanced =
Life Support emergency medical assistants (EMAs). METHOD: A modified =
randomized crossover design was used. The Pharyngeal Tracheal Lumen =
Airway (PTL), the laryngeal mask (LM), and the esophageal tracheal =
Combitube (Combi) were compared objectively for success of insertion, =
ventilation, and arterial blood gas and spirometry measurements =
performed upon hospital arrival. Subjective assessment was carried out =
by EMAs and receiving physicians at the time of device use, and an =
eight-question comparative evaluation of all devices was completed by =
EMAs at study conclusion. A comparative cost analysis was performed. =
Operating room training was compared with mannequin training for the LM. =
Autopsy findings and survival to hospital discharge were analyzed. The =
study took place in four non-ALS communities over four and a half years, =
and involved 470 patients in cardiac and/or respiratory arrest. EMAs had =
automatic external defibrillator training but no endotracheal intubation =
skills. RESULTS: Successful insertion and ventilation: Combi, 86%; PTL, =
82%; LM, 73% (p =3D 0.048). No significant difference was found for =
objective measurements of ventilatory effectiveness (ABGs and =
spirometry). Significant comparative differences in subjective =
evaluation were found. CONCLUSIONS: The PTL, LM, and Combi appear to =
offer substantial advances over the OA/BVM system. Although the most =
costly, the Combitube was associated with the least problems with =
ventilation and was the most preferred by a majority of EMAs.

PMID: 9709312 [PubMed - indexed for MEDLINE]=20

____
Nick Nudell, NREMT-P
Education Coordinator
Glacier County EMS
www.glacierems.com
Northern Rockies Medical Center
Cut Bank, MT
nick@glacierems.com

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    <TD>
      <DIV><FONT size=3D2>Here is some supporting data:</FONT></DIV>
      <DIV>&nbsp;</DIV>
      <DIV><FONT size=3D2>Prehosp Emerg Care 1997=20
Jan-Mar;1(1):1-10</FONT></DIV></TD>
    <TD align=3Dright><FONT face=3DTahoma =
size=3D2></FONT></TD></TR></TBODY></TABLE>
<DD><BR><FONT size=3D2><B>The PTL, Combitube, laryngeal mask, and oral =
airway: a=20
randomized prehospital comparative study of ventilatory device =
effectiveness and=20
cost-effectiveness in 470 cases of cardiorespiratory=20
arrest.</B><BR><BR><B>Rumball CJ, MacDonald D.</B><BR><BR>Paramedic =
Academy,=20
Justice Institute of British Columbia Faculty of Medicine, University of =
British=20
Columbia, Canada.<BR><BR>PURPOSE: A prehospital study was conducted to =
assess=20
and compare three alternative airway devices and the oral airway for use =
by=20
non-Advanced Life Support emergency medical assistants (EMAs). METHOD: A =

modified randomized crossover design was used. The Pharyngeal Tracheal =
Lumen=20
Airway (PTL), the laryngeal mask (LM), and the esophageal tracheal =
Combitube=20
(Combi) were compared objectively for success of insertion, ventilation, =
and=20
arterial blood gas and spirometry measurements performed upon hospital =
arrival.=20
Subjective assessment was carried out by EMAs and receiving physicians =
at the=20
time of device use, and an eight-question comparative evaluation of all =
devices=20
was completed by EMAs at study conclusion. A comparative cost analysis =
was=20
performed. Operating room training was compared with mannequin training =
for the=20
LM. Autopsy findings and survival to hospital discharge were analyzed. =
The study=20
took place in four non-ALS communities over four and a half years, and =
involved=20
470 patients in cardiac and/or respiratory arrest. EMAs had automatic =
external=20
defibrillator training but no endotracheal intubation skills. RESULTS:=20
Successful insertion and ventilation: Combi, 86%; PTL, 82%; LM, 73% (p =
=3D 0.048).=20
No significant difference was found for objective measurements of =
ventilatory=20
effectiveness (ABGs and spirometry). Significant comparative differences =
in=20
subjective evaluation were found. CONCLUSIONS: The PTL, LM, and Combi =
appear to=20
offer substantial advances over the OA/BVM system. Although the most =
costly, the=20
Combitube was associated with the least problems with ventilation and =
was the=20
most preferred by a majority of EMAs.<BR><BR>PMID: 9709312 [PubMed - =
indexed for=20
MEDLINE] </FONT></DD></DIV>
<DIV>&nbsp;</DIV>
<DIV><FONT face=3DTahoma size=3D2>____<BR>Nick Nudell, =
NREMT-P<BR>Education=20
Coordinator<BR>Glacier County EMS<BR><A=20
href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2002/3D"http://www.glacierems.com">www.glacierems.com</A><BR>Northern =
Rockies=20
Medical Center<BR>Cut Bank, MT<BR><A=20
href=3D"mailto:nick@glacierems.com">nick@glacierems.com</A></FONT></DIV>
<DIV>&nbsp;</DIV>
<DIV><FONT face=3DTahoma size=3D2><BR></FONT>&nbsp;</DIV></BODY></HTML>

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