Laryngeal mask or laryngeal tube. Which is better for extraglottic airway management by emergency medical services?

Background. In emergency medicine extraglottic airways (EGAs) are-because of their ease of use-not only alternatives in the management of the difficult airway but also first choice for emergency airway management in special circumstances. The variety of manufacturers and types of EGAs makes identification of the optimal EGA for the one's own emergency medical services difficult. Method. On the basis of a Medline search this overview compares the laryngeal mask (LM) and the laryngeal tube (LT) for emergency medicine. Results and conclusions. Current literature arising from emergency medicine is insufficient to compare the quality of these EGAs. Clinical studies demonstrate comparable quality of LM and LT for the operator's purposes. Nevertheless new observations from out-of-hospital use of the LT in emergency situations point out severe complications partially leading to life-threatening sequelae, so that a modified standard for application of the LT is recommended. The advantages of the EGA with gastric access reducing stomach-distension, risk of aspiration and allowing control of the airway's placement are discussed. Currently the benefit of training and routine use in the application of the LM or LT seems to be superior to the potential differences in quality of these EGAs. Thus, the choice of the optimal EGA for the one's own emergency medical services should take into consideration these circumstances.