Evaluation of the intubating laryngeal mask airway™ used by occasional intubators in simulated trauma

This observational study assessed the potential role of the intubating laryngeal mask airway (ILMA(TM)) for use by emergency care givers with limited laryngoscopy skills. Six ambulance officers with advanced airway training, five doctors with intubation experience and five doctors without intubation experience were given a short instruction course on the use of the ILMA. They subsequently used the device on 80 consenting subjects anaesthetized for elective surgery after the application of cricoid pressure and manual in-line stabilization of the cervical spine. All patients were successfully ventilated via the ILMA. Mean (SD) times in seconds to ventilation were 27 (10), 33 (18) and 47 (22) respectively in the occasional intubator ambulance officers, occasional intubator doctor and naive intubator groups. The numbers (percentage) failures to intubate via the ILMA in each group were 2 (7%), 5 (20%) and 4 (16%) respectively. Mean (SD) times in seconds to intubation were 32 (23), 32 (17) and 36 (25). There was no evidence of "learning" with repeated use. The feedback forms were strongly supportive of a prehospital trial and also of having an ILMA available during all intubations. Participants almost universally rated the ILMA as easy to use. This study supports further evaluation of the ILMA in a large prehospital trial.