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LMA - scope of practice


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Ok guys, I am writing a Pre hospital emergency Care course and within this, I am talking about the usage of Airway adjuncts. Now tradtionally I have taught the use of NPA and OPA adjuncts. However, the teams I am training, are a bit out from Emergency Medical Service assistance and are in areas where exposure to chemicals such as amonia is high.

I am wanting to teach the staff how to utilise LMA's. The patient clientelle for these teams would be adults and with the ease of inserting the devices I think they would be beneficial to learn and utlise. My question, is what skill level is LMA with your services - Here in NZ it is EMT -B skill and is introduced on the CFR courses *PHEC* I dont see it as a skill that is reserved for ACLS, nurses in the hospitals are all trained to insert LMA's as a basic life support adjunct.

Please do not deviate to Combi tubes or intubation. I am a firm believer in intubation being the gold standard for airway support and still support pre hospital intubation, but alot of push exists for supraglottic airway use, so if the EMS teams are putting LMA's in instead of ET tubes, then would the insertion of them be beneficial for industrial rescue squads? It then leaves a set of hands free as a bag mask could be attached and easily managed rather than having to hold a jaw thrust with an OPA and c-grip for BVM usage.

Thanks in advance guys

Scotty

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For us LMA's are an EMT-Basic skill. We have been eyeballing the SALT as an basic intubation skill but it has not come through yet.

I would think that the decision to use LMA's in your industrial rescue squads would be more related to wither or not they would get in trouble for doing it as opposed to it's usefulness.

Edited by DFIB
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Just one little thing: Have you thought of using a LT-Tube instead of a LMA? The "system" is the same as the LMA but there are various studies that show that the LT is easier to use and teach to group like you're trying to instruct.

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The LMA is what we use here Krumel, the Ambulance Service has used it for years and there are no signs of it being changed over in favour of the King LT. There was a small trial here of the King LT a few years ago at a single provincial station with long transport times but nothing came of it. The LMA is cheap, easy to insert and does the trick.

Scott, check your email

Edited by Kiwiology
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Cheers Ben. I think that as long as the local EMS providers are aware LMAs are carried I don't see the problem. I think they would be a much better adjunct in these work environments than OPAs. Soon see though

(null)

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Our Advanced Cardiac first responders use the I-Gel airway, No messing with trying to inflate it, cheap as well. Simple to use.

I-Gel Airway? I am curious indeed :)

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Our Advanced Cardiac first responders use the I-Gel airway, No messing with trying to inflate it, cheap as well. Simple to use.

Oh Ireland why must you have so many levels of first responder, it just makes things confusing!

The I-Gel is like the LMA with the cuff already inflated and shaped a bit differently

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