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Airway Management with the King Airway LTD Device.

Airway Management with the King Airway LTD Device. By Kevin Malicky. Objectives. Understanding the description and use of King LTD. Requirements needed for LTD use Clinical studies involving King LTD airways Sizes and insertion of King LTD The overall success rate of King LTD

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Airway Management with the King Airway LTD Device.

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  1. Airway Management with the King Airway LTD Device. By Kevin Malicky

  2. Objectives • Understanding the description and use of King LTD. • Requirements needed for LTD use • Clinical studies involving King LTD airways • Sizes and insertion of King LTD • The overall success rate of King LTD • Minimal disadvantages to LTD use

  3. King Airways • The KING LTD is supplied clean and is a non-sterile device • It consists of a curved tube with ventilation apertures located between two inflatable cuffs. • The distal cuff is designed to seal the esophagus • Proximal cuff is intended to seal the oropharynx

  4. King LTD Uses • The nurse can insert the King LTD in emergency situation with minimal training. • Cardiac arrest • Respiratory distress/arrest.

  5. Training Requirements • Quarterly training with SIM’S man on insertion of King LTD. • Annual training videos on updates for insertion. • OR time for insertion required each quarter to maintain competency.

  6. Difficult Airway / Emergency Airway Use

  7. Clinical Studies • Insertion was determined to be easy and a patent airway was achieved in all 50 patients. • Successful mechanical ventilation in 169 of 175 patients. With 3 patients unsuccessful due to high pressure volumes. • In a trial of 60 all 60 patients had the LTD inserted successfully on the first attempt.

  8. King Airway Sizes • The King LTD is available in size 3, 4, & 5 and can be used with patients 35 inches (90 cm) and taller • Adult sizes are based on the patient's height. • Size 2 and 2.5 are only available For Pediatric. • Pediatric sizes are based on the patient’s height or weight

  9. How do you insert a King LTD • Insert the airway until the hub is at the level of the teeth. • Inflating the cuffs • Withdrawing the KING LTD airway until ventilation is optimized results in the best depth of insertion. • No need to check for Bilateral breath sounds.

  10. Advantages • Emergency ventilation can take place within 15 seconds without a laryngoscope. • Requires minimal movement of patient head. • Requires minimal education to insert. • The King laryngeal airway is designed to be inserted without direct visualization. • Minimal risk of aspiration. • The KING LTD provides a secure, non-intubating emergency airway when direct laryngoscopy is not feasible

  11. Disadvantage • Only make limited sizes. • The KING LTD can be used in routine procedures only up to 8 hours. • Unable to place medication down the tube. • Trauma related to balloon in trachea.

  12. Summary • With minimal experience the nurse can insert the King LTD. • The patient can be ventilated with a King Airway. • Minimal aspiration with a King Airway. • Patient can be intubated without a laryngoscope.

  13. References: • Don Michael TA. Esophageal obturator airway. Med Instrum.1977;11:331–3. • Genzwuerker H, Dhonau S, Ellinger K. Use of the laryngeal tube for out-of-hospital resuscitation. Resuscitation 52:221–224, 2002. • Guyette F, Greenwood M, Neubecker D, et al. Alternate airways in the prehospital setting. Resource document to NAEMSP position statement. www.naemsp.org, 2006.

  14. References: • Stone B, Chantler P, Baskett P. The incidence of regurgitation during cardiopulmonary resuscitation: A comparison between the bag valve mask and the laryngeal mask airway. Resuscitation 38:3–6, 1998

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