Simulated rescue airway use by laypersons with scripted telephonic instruction

BackgroundThe King LT-D is a supraglottic airway with the potential for use by trained first responders in settings where access to advanced life support interventions by a physician or Emergency Medical Services may be delayed.ObjectivesTo determine the success rate of novice users in the telephone-directed placement of the King LT-D airway during a simulated respiratory arrest in order to establish the feasibility of conducting further study into use of the device by first responders after minimal training.MethodsWe conducted a prospective study using 30 undergraduate students without medical training and a high-fidelity simulator. Subjects were instructed using a telephone-directed protocol to assess the airway, place the King LT-D and ventilate the simulator. Subjects were assessed on the successful placement of the King LT-D, time to placement, and perceived ease of use of the device. A Likert scale was used to identify the participant's perceptions. Subjects with CPR/AED certification were compared to those without such training. Data were analyzed using descriptive statistics and a t-test.ResultsThe King airway was successfully placed in 80% (95% CI: 65; 95) of attempts. Success rate did not differ with prior CPR training. The median time to successful placement was 1 min 50 s (95% CI: 1 min 6 s; 2 min 39 s). The participants perceived the King LT-D to be easy to place in 90% (27/30) of cases.ConclusionThe King LT-D is simple enough to use, that it can be successfully placed by novice users with minimal telephonic instruction. This suggests that further studies could be conducted to determine the effect of King LT-D use on quality of airway management in scenarios depicting management of cardiac arrest by first responders in areas with delayed access to ALS interventions.