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LMA

Charles Brault c_brault at yahoo.com
Thu Apr 6 08:06:38 BST 2006


Yes indeed
   
  Small number
   
  But
   
  Anybody that has worked in a system that uses will tell you of the initial insertion problem. Largely resolved with better training and hydrogel.
  To be read as : the filure numbers are going to come on the first.. let's say... 26 tubes
  at INSERTION that is
  I am more concerned with the VENTILATION issue
   
  The concern I need answered with the BLS LMA are :
  - Training (recogniition of problems)
  - Regurgitation
  - Displacement
   
  Charles

Ian Seppelt <SeppelI at wahs.nsw.gov.au> wrote:
  Hang on, read the paper not just the abstract! The LMA was successful in
26/26. The Combitube failed in 2/26. The only reason for "p>0.05" weas
lack of power due to small numbers. Have a look at table 1 from the
paper (attached). I would still prefer the device that 100% of
inexperienced operators inserted successfully, not the one that only 92%
of inexperienced operators inserted successfully (expressing the data in
a different way).

Cheers, Ian

Ian Seppelt FANZCA FJFICM
Staff Specialist in Intensive Care Medicine
The Nepean Hospital, 
PO Box 63, Penrith NSW 2751
Clinical Lecturer, University of Sydney


>>> c_brault at yahoo.com 6/04/2006 1:11am >>>

Yardy N, Hancox D, Strang T., 
A comparison of two airway aids for emergency use by unskilled
personnel. The Combitube and laryngeal mask., 
Anaesthesia 1999 Feb;54(2):181-3

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.


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