RE: Services using LMA's

[Robert Cole <EMCOLERS@adaweb.net>]

I have mixed feelings on the LMA. 

Pro: It is usable in both adult and pediatric populations, making it a bonus
over the combi-tube.

Con: It does not "secure" the airway, only isolate it, and there is some
discussion as to how well it does that.  Here the combi-tube (IMHO) provides
better protection.  As the small print in the ACLS states, adequate
pre-hospital use (of the LMA)has not been studied, its use is largely
related to the operation room.  While some surgeries involve significant
movement (plastic surgery and orthopedic procedures come to mind), its uses
has been previously isolated to patients with empty stomachs.


Robert S. "Steve" Cole
Paramedic, CCEMTP
Education Department
Ada County Paramedics 
208-375-7079
emcolers@adaweb.net

"...A mind stretched with new ideas never regains its former shape"


-----Original Message-----
From: Wesley Copeland Sr., MICT, NREMT-P, CCEMT-P
[mailto:wcemt@terraworld.net]
Sent: Tuesday, January 08, 2002 7:41 PM
To: flightmed@flightweb.com
Subject: Re: Services using LMA's


> I am also curious about the use of the combitube vs
> the LMA as an alternative airway adjunct, Especially
> the intubating LMA's.

Although this question was not directed at me, I'd like to add my 2 cents.
Having used both the Combitube and LMA (yes the intubating one) I think both
offer a good airway when Intubation fails.  However, why play around with
intubating through an  LMA when you can stick a LMA or combitube, have a
secure airway and move on to something else that could be done for your
patient?    I think the Intubating LMA is a good idea, but I think it's use
in our field is limited for no other reason than the time factor.  99% of
patients we fly have more than just airway trouble.  I want to secure an
airway quickly and move on to other needed treatments.  For the record, I do
think the LMA's fill a much needed gap in the pediatric and small adult
population.  We were without a secondary airway for these people for far to
long!

Wesley Copeland Sr., MICT, NREMT-P, CCEMT-P




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