Introduction of the intubating Laryngeal Mask Airway™ in a prehospital emergency medical unit

Objectives. - Assessment of the intubating Laryngeal Mask Airway (TM) in a prehospital emergency mobile unit (PEMU). Study design. - Observational study. Methods. - All the emergency physicians and nurses of the PEMU were trained with the intubating laryngeal mask (ILMA) handling on manikin and a learning curve was carried out. One year after the initial formation, a reassessment of the operators was performed. Following the initial formation, all the vehicles of the PEW were equipped with ILMA and during 15 months all cases of ILMA use were recorded. The success rate and the difficulties met were analysed. Results. - Initial formation on manikin showed that at least 8 handling of the device were mandatory to achieve a 100% success rate. A significant reduction of tracheal tube insertion delay was observed up to the eight manipulations. One year after the initial formation, a significant loss of performance was observed. Over the clinical study period 20 ILMA were used with adequate ventilation through the mask in all cases and a possible intubation in 80% of the patients. Conclusion. - The ILMA is a potential useful device in the prehospital setting. Initial formation and maintenance of the skill acquired with this technique are essential. (c) 2006 Elsevier Masson SAS. Tous droits reserves.