WHAT DO YOU SUGGEST ?

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Now thats odd\

The ILMA is as easy to place as the LMA. If you choose, you can end up with 
the gold standard, an ETT and leave the LMA device in. So, you have  a 
double protection vs aspiration.

What you said dosent make sense at all. The ILMA is easy to use not at all 
complicated. We use it all the time, I teach it as well as near every other 
airway device currently avaliable and useable in emergency situations. The 
ORs here have the ILMA as their primary backup device. They love it. Asia T. 
had a 95% success rate with blind intubation using the ILMA and that data 
has since been repeated.

Noone would say an ETT isnt a better airway and protects vs aspiration 
better than all the backups avaliable. After all, thats why they are called 
backups. In fact, a review of millers anesthesia and Ron Walls books both 
state clearly there is nothing better tan an ETT. I stands to reason then, 
that any backup airway device that can end with an ETT is superior than any 
other. Ergo: ILMA is the best thing avalaible.

m
----- Original Message ----- 
From: "MARK FORREST" <atacc.doc at btinternet.com>
To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Sent: Thursday, August 31, 2006 4:28 PM
Subject: Re: WHAT DO YOU SUGGEST ?


> Mmmm! Evidence that the ILMA is really better in terms of 
> aspiration.....very limited at best?!
>
> LMA, ILMA, AMD and Combitube are NOT definitve airways and all risk 
> aspiration, yet they are all used to an ever increasing extent in all 
> areas of resuscitation and we have not seen a huge rise in aspiration 
> pneumonia in our ITUs. None of them are 100%, but you overstate the 
> genuine risks.
>
> We used ILMA pre-hospital for several months and then abandoned it as 
> unecessary, over-complicated and over-rated.
>
> Our team like and stick to the basic LMA as it is simple and easy to use 
> without any thought. I have seen too many 'trained' and 'experienced' 
> people in our trauma simulation sessions struggling to figure out ILMAs 
> and combitubes when under pressure. I would hate to see how they manage 
> such devices when it is 'real'.
>
> keep it simple and safe if you wish to reduce risk.
>
> Regards
> Mark F
> UK
>
>
> ----- Original Message ----
> From: Mike <mmackinnon at cox.net>
> To: "Trauma & Critical Care mailing list" <trauma-list at trauma.org>
> Sent: Thursday, 31 August, 2006 11:43:53 PM
> Subject: Re: WHAT DO YOU SUGGEST ?
>
>
> you know what LMA stands for?
>
> Let eM Aspirate.
>
> LMAs have no place in EMS.  ILMAs are the best choice or even a combitube
> will protect against aspiration better than an LMA.
>
> m
> ----- Original Message ----- 
> From: "MARK FORREST" <atacc.doc at btinternet.com>
> To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
> Sent: Thursday, August 31, 2006 3:06 PM
> Subject: Re: WHAT DO YOU SUGGEST ?
>
>
>> LMA......simple, quick, reliable and easy to convert to
>> intubation/definitive airway as soon as possible...why struggle!
>> Mark F
>> Anaes/Crit Care Cons,UK
>>
>>
>> ----- Original Message ----
>> From: ofiara at comcast.net
>> To: trauma-list at trauma.org
>> Sent: Thursday, 31 August, 2006 10:03:42 PM
>> Subject: WHAT DO YOU SUGGEST ?
>>
>>
>>>From an EMS standpoint, with the various pt.population,(old to young).
>>>Reasons for an advanced airway:(trauma-medical-burns), and the places you
>>>may be intubating,( the box, a darkly lighted small room in a house-on
>>>scene of a MVC), what do you suggust as a back-up to the ETT. A
>>>Combi-tube, a LMA or a bougie ? Thanks  for any input.
>>  Larry Ofiara, R.N.
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