First responders and LMA'S

[scottymedic]

Hi all, hope all is well with you all. I have done a search to make sure this hasn't been posted before or I haven't posted it and forgotten (old man brain setting in lately so much on to tell).

Are any first responders (CRF's or industrial rescue squads etc) in your areas utilising LMA'S as part of their airway management techniques? I am asking in the event of cardiac/respiratory arrest and in situations where they may have to move a patient with one in situ.

I teach this on the CFR course I run (Like the FPOS Intermediate curriculum for my British colleagues or Pre Hospital Emergency Care (PHEC) for others out there. The initial course for all content is four practical days with continual clinical refreshers and updates. I believe these staff can utilise the tools appropriately and wondering if anyone else teaches this or it is part of their curriculum.

Many thanks and again, hope all well and keeping healthy and happy

Scotty

[paramedicmike]

LMAs have been removed as an airway device from every first responder related service in my area. They were removed years ago. LMAs fell out of favor when combitubes came out. Combitubes fell out when the King airway devices came out.

[celticcare]

Combis and kings aren't utilised here. Have never used either Sent from my iPad using Tapatalk

[Timmy]

I’m unaware of the requirements for the FPOS or PHEC courses but I’m quite certain first responders in Australia do not use LMAs. I’d just like to clarify your referring to first responders in the sense of a lay person who has completed the four day course and not a paramedic acting in a first responder role?

Having trained volunteer first responders before I’d lean on the side of caution when it comes to advanced airway techniques. During my paramedic degree we spent quite an amount of time on LMA’s, there’s a lot involved regarding anatomy and physiology, remembering the different sizes to the weight of the patent, practising and going through the clinical practise guidelines and clinical work instructions – I think we spent a week all up doing lectures and practicals on airway management with an intensive care paramedic then of course we were examined theoretically and practically. Likewise with the nursing ALS course, lots to read and practise before you sit your assessment.

Whenever I’ve been taught airway management the importance of basic manoeuvres and adjuncts is paramount. I think the student should be affluent with a good triple airway manoeuvre, getting a good seal with the bag value mask, using suction, inserting an OPA and maintaining good ventilation. I think these skills should be the focus of the first responder’s role rather than teaching advanced skills in four days. Moving the patient is another kettle of fish, they have to be confident the tube is secure, be aware of the risk of aspiration, tube displacement, ideally have cardio/respiratory monitoring etc.

If these people are operating within close proximity (< 1 hour) to medical help then I think basic skills should be taught.

Just my opinion, I haven’t meet your students.

[celticcare]

Yes timmy am referring to the four day training course. I don't think it's that hard to insert an LMA especially when the size and weight range is written on the package/device and in the essence of protecting the airway where sometimes they may be the only rescuer to arrive, I'd rather they put an LMA down and secured the airway to then deliver respirations with cpr than try and struggle with an opa and mask scenario. LMA is a basic airway skill in a lot of ways as it is at bls professional level (nurse and ambulance) here in nz and I have faith and confidence in the students Ability to utilise the skill effectively. Like you say though, err on the side of caution. But then having faith in your students abilities counts too, Sent from my iPad using Tapatalk