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Unlabelled: In the current guidelines of the European Resuscitation Council (ERC), tracheal intubation, as an instrument for securing the airway during resuscitation, has become less important for persons not trained in this method. For those persons, different supraglottic airway devices are recommended by the ERC. The present investigation deals with the application of the laryngeal tube disposable (LT-D) during pre-hospital resuscitation by paramedics., Methods: During a period of 2 years (2006-2008), we registered all cardiac arrest situations in which the LT-D had been applied according to the ERC guidelines 2005. Therefore, we investigated one emergency medical system in Germany., Results: During the defined period, 92 resuscitation attempts, recorded on standardised data sheets, were included. The LT-D was used in 46% of all cardiac arrest situations. Overall, the LT-D was successfully inserted in more than 90% of all cases on first attempt. In 95% of all cases, no problems concerning ventilation of the patient were described., Conclusion: As an alternative airway device recommended by the ERC in 2005, the LT-D may enable airway control rapidly and effectively. Additionally, by using the LT-D, a reduced "no-flow-time" and a better outcome may be possible.

Objectives: The purpose of this study was to determine effects of different airway devices and tidal volumes on lung ventilation and gastric inflation in an unprotected airway., Methods: Thirty one non-anaesthesia house officers volunteered for the study, and ventilated a bench model simulating an unintubated respiratory arrest patient with bag-valve-facemask, laryngeal mask airway, and combitube using paediatric and adult self inflating bags., Results: The paediatric versus adult self inflating bag resulted with the laryngeal mask airway and combitube in significantly (p<0.001) lower mean (SEM) lung tidal volumes (376 (30) v 653 (47) ml, and 368 (28) v 727 (53) ml, respectively). Gastric inflation was zero with the combitube; and 0 (0) v 8 (3) ml with the laryngeal mask airway with low versus large tidal volumes. The paediatric versus adult self inflating bag with the bag-valve-facemask resulted in comparable lung tidal volumes (245 (19) v 271 (33) ml; p=NS); but significantly (p<0.001) lower gastric tidal volume (149 (11) v 272 (24) ml)., Conclusions: The paediatric self inflating bag may be an option to reduce the risk of gastric inflation when using the laryngeal mask airway, and especially, the bag-valve-facemask. Both the laryngeal mask airway and combitube proved to be valid alternatives for the bag-valve-facemask in this experimental model.

The purpose of this study was to assess the levels of lung and gastric tidal volumes paramedics achieve when performing ventilation with bag-valve-mask, laryngeal mask, and Combitube. Twenty paramedics performed ventilation with a bag-valve mask, laryngeal mask, and Combitube in a bench model simulating an unintubated cardiorespiratory arrest patient. Lung and gastric tidal volumes and lung and gastric peak airway pressures were subsequently measured. The results showed that mean +/- SEM lung tidal volumes were significantly higher with the laryngeal mask and Combitube compared to the bag-valve-mask (701 +/- 264 vs. 742 +/- 311 vs. 353 +/- 110 mL, respectively). No gastric inflation occurred with the Combitube; gastric inflation was significantly lower with the laryngeal mask compared to the bag-valve-mask (25 +/- 15 vs. 230 +/- 25 mL, respectively). Both the laryngeal mask and Combitube proved to be valid alternatives for bag-valve-mask ventilation in our bench model simulating an unintubated patient with cardiorespiratory arrest.