The use of the laryngeal mask airway by nurses during cardiopulmonary resuscitation. Results of a multicentre trial.

Abstract

A multicentre study was undertaken to assess the potential value of the laryngeal mask airway when inserted by ward nurses during resuscitation as a method of airway management, prior to the arrival of the Advanced Life Support Team with tracheal intubation capability. The nurses underwent a training programme agreed by all the participating hospitals and followed an identical protocol and data recording system. One hundred and thirty nurses were trained and 164 cases of cardiac arrest were studied. The laryngeal mask airway was inserted at the first attempt in 71% and at the second attempt in 26% of cases. Satisfactory chest expansion occurred in 86% of cases. The mean interval between cardiac arrest and laryngeal mask airway insertion was 2.4 min. Regurgitation of gastric contents occurred before airway insertion in 20 cases (12%), during the insertion in three cases (2%), but there was clinical evidence of pulmonary aspiration in only one patient, who survived to leave hospital. We conclude that the laryngeal mask airway offers advantages over other methods of airway and ventilation management, such as the bag-valve-mask or mouth-to-mouth methods that are currently used by ward nurses in resuscitating patients with cardiac arrest. In this study, the laryngeal mask airway was not being compared with the tracheal tube.