Comparison of Laryngeal Mask Airway Seal Between Anesthesiologists and Individuals Without Previous Airway Experience

J Emerg Med. 2024 Apr;66(4):e470-e476. doi: 10.1016/j.jemermed.2023.11.024. Epub 2023 Nov 30.

Abstract

Background: Tracheal intubation is the gold standard for airway management in emergency medicine, but more difficult to apply for inexperienced individuals than laryngeal mask airway (LMA).

Objective: The aim of our study was to investigate if inexperienced individuals are able to secure the airway with the help of LMA after a short introduction. A second aim was to evaluate Thiel-fixed specimens against unfixed ones.

Methods: In a body donor model, LMA application was evaluated between medical students without previous airway experience and anesthesiologists by comparing the sealing of the larynx using a water column applied to the esophagus.

Results: LMAs were successfully applied in 46 out of 55 (83.6%) attempts by medical students and in 30 out of 39 (76.9%) attempts by anesthesiologists. Among medical students, 14.1% of all LMA applications were primarily leaky, compared with 18.8% in anesthesiologists. Esophageal sealing was better in Thiel-fixed specimens (leakage 10.9%) compared with unfixed specimens (leakage 22.9%). Our data showed no significant difference between anesthesiologists and medical students in terms of sealing of LMA. Therefore, we conclude that medical students without previous airway experience can quickly learn to apply LMA sufficiently and thus, achieve aspiration protection similar to anesthesiologists.

Conclusion: Medical students without previous airway experience can successfully insert LMAs after a short introduction. Thiel-fixed specimens are suitable for studies as well as for training in LMA application.

Keywords: Thiel embalming; aspiration; difficult airway; emergency; emergency medical services; esophageal pressure; extraglottic airway device; regurgitation; supraglottic airway device; upper airway.

MeSH terms

  • Airway Management
  • Anesthesiologists
  • Esophagus
  • Humans
  • Intubation, Intratracheal
  • Laryngeal Masks*