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Fri Sep 1 10:50:12 BST 2006

Evidence based medicine, level of evidence grade 1 to none, expert opinion, anecdotes or fairytales. It should be about providing medical information, not personal vendettas to make a point.

LMA, ILMA, combitube or ETT, it depends on the training, skills, experience and supervision for what how and when it should be used by whom.
In case of out of hospital airwayfailure, you need a temporally solution, a definitive airway is the best but not always possible. In that case a LMA is the most simple, elegant and safe solution. When arrived in the hospital, with more knowledge (experienced staf (anesthesiology-surgery-ENT-ODP etc), advanced medication and equipment (Bonfills-Glydescoop/Airtraq-tracheotomy etc) then there is the moment for the definitive airway.

And yes, there might be a discusion on what is "simple", but there can be hardly a discusion that it means that it should be as "idiot proof" as possible.

M.G.M. Scot MD
Consultant Anesthesology
Chairman Emergency Medicine Section, Dutch Society of Anesthesiology

Department Anesthesiology & Pain
Medisch Centrum Alkmaar
Alkmaar
the Netherlands
+31 (0)72 548 3124 / 3123
Snailmail
PO Box 501
1800 AM Alkmaar
the Netherlands
Email
M.Scot at MCA.Nl

Ability is what you're capable of doing. Motivation determines what you do.
Attitude determines how well you do it.

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