Читать книгу Emergency Medical Services - Группа авторов - Страница 95

The LT is a SGA that consists of a single lumen tube (Figure 3.8). A single insufflation port simultaneously inflates two balloon cuffs. The LT design is supposed to facilitate more consistent placement in the esophagus than its predecessor, the esophageal‐tracheal Combitube^®. Insertion of the LT airway is very similar to that of the Combitube. The rescuer inserts the LT blindly into the patient’s mouth, positioning the smaller distal balloon in the esophagus and the larger proximal balloon in the oropharynx. After balloon cuff inflation, the rescuer may need to withdraw the tube slightly to seal the balloon against the oropharyngeal structures.

Disposable versions of the device exist for prehospital application. There is also a version with an esophageal port permitting concurrent placement of an orogastric tube. Complications, while infrequent, can include laryngospasm, vasovagal asystole, and glottic hematoma [49]. In addition to three different adult sizes, pediatric sizes of the LT are also available. Given the simplicity of its design, the LT can be rapidly placed by EMS clinicians with a range of skills in a variety of clinical settings. In a randomized controlled trial of 3,000 adult out‐of‐hospital cardiac arrests, a strategy of initial LT use was associated with improved adult out‐of‐hospital cardiac arrest outcomes compared with a strategy of initial ETI [46, 49].

Figure 3.8 LT airway.