LMA, Who can use them?

[smle]

When I was in EMT-B school last fall, they trained us in the use of Laryngeal Mask Airways, or, LMAs. Now that I'm working for an ambulance service, I see in our protocols that the LMA is a Paramedic only device.

In your Country/State/Service, who, if anyone, can use LMAs?

I know that this device was originally for operating room use and was adopted by EMS. It certainly doesn't secure an airway as well as a Combi-Tube or ET tube.

[PB MeDiC]

WI - not used in prehospital, ETs & CTs only.

[Guest]

Oregon - EMT-I & Paramedics

(Combitube --> EMT-B, I, & P)

(ETT --> Paramedic only)

[Ridryder 911]

They are considered an advanced airway here too.

Be safe,

Ridryder 911

[vs-eh?]

LMA use is part of the Canadian Medical Assoc. NOCP's for advanced care and critical care paramedics. I had to "learn" how to use one in school. IMO it is as easy to insert as an OPA and offers somewhat better ventilation, though less a/w protection than an ETT.

I dunno what they cost but I assume that is the limiting factor why they aren't in widespread use.

In Ontario I don't know if they are used except by critical care paramedics as a failed/difficult airway option.

[Acosell]

I also had to learn LMA in PCP school. I've only heard of it being used in one service--Simcoe County--which is all BLS. LMAs are part of their protocol for VSA patients.

[strippel]

Not allowed to use them. My wife is an anesthesia tech, and is very familiar with them, from the OR.

One command Doc around here is pushing the DOH to allow them for BLS, but I don't see that every happening.

Our nursing education facilitator (the nurse responsible for keeping the OR staff current with training) wonders why EMS would be interested in LMAs. She states CT and ETT are much better and safer.....

[1EMT-P]

We currently do not use the LMA... Our EMT's are allowed to use the CBT & our Medics are allowed to use both the CBT & ETT.

An LMA would be useful in patients that are difficult to intubate or in patients who are too small for the CBT. They also would be useful for rural providers who do not intubate very often.

[akroeze]

I guess it comes down to this... what advantage does the LMA have over a Combitube?

[emtnerd]

Where I live the lower levels in EMS use them at all and I think paramedics here can use them, but don't because they are so expensive. In my EMT course we were taught how to use LMA's and Combitubes but they are not yet in our scope. Hopefully, with some new legislation coming in this may soon change. Keepin' my fingers crossed.