[Statement of the Austrian Society for Anesthesiology, Resuscitation and Intensive Care Medicine (ÖGARI) on the use of laryngeal tubes by ambulancemen and paramedics].

Anaesthesist

European Resuscitation Council Advanced Life Support (ERC ALS) Education and Science Committee, 2845, Niel, Belgien.

Published: June 2019

AI Article Synopsis

  • ÖGARI is addressing concerns about complications from laryngeal tubes in emergency settings by recommending a shift in training for emergency paramedics from endotracheal intubation to extraglottic airway management (EGA).
  • The recommended training should cover at least 40 hours of theory, hands-on practice with manikins, and 20 successful applications on patients with medical supervision, using either laryngeal masks or laryngeal tubes as appropriate.
  • Only 2nd generation EGAs should be used, and after placement, it's essential to monitor cuff pressure and perform gastric suction, while ambulance personnel should mainly focus on bag-mask ventilation rather than using EGAs.

Article Abstract

Due to an increasing number of severe complications reported during the prehospital application of laryngeal tubes, the Austrian Society for Anesthesiology, Resuscitation and Intensive Care Medicine (ÖGARI) is prompted to formulate a respective statement. With regard to the current training situation and the applicable laws, ÖGARI recommends to convert the "Emergency Competence for Endotracheal Intubation (NKI)" for emergency paramedics into an "Emergency Competence for Extraglottic Airway Management, (NK-EGA)". Training should include at least 40 h of theoretical instruction, hands-on training on the manikin to secure mastery of the methodology and at least 20 successful applications under clinically elective conditions in adult patients under direct medical supervision. Here, depending on local conditions, both laryngeal mask and laryngeal tube can be used. In the prehospital environment, the device must be used which has been trained as mentioned above. Only 2nd generation EGA should be used. After successful EGA placement timely cuff pressure monitoring and gastric suction should be performed. The use of an EGA by ambulance-men cannot be recommended; these have to be limited to bag-mask ventilation.

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Source
http://dx.doi.org/10.1007/s00101-019-0606-yDOI Listing

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