LMA

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Jules, 
 
A few other places that I'm aware of allow Combitube use by EMT-B's as a  
primary airway, which is well-supported by the evidence. 
 
Cautious anecdote: While I'm with you on the "never seems to wind up in the  
trachea..." there are studies that describe up to 10% rate of tracheal  
placement, and further, I'm aware of a terrifying tale of a man who arrived  pretty 
dead into the resus bay with a Combitube in his throat. The crew was  
ventilating through Port "#1" while the Combitube tube was actually seated in  the 
trachea. This is analgous to an unrecognized esophageal intubation with a  
regular ETT. 
 
IMHO: ETCO2 and/or EDD use ought to be mandated for anyone using the  
Combitube as a rescue airway. Both will work. 
 
Scott Hax
Lebanon NH 

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