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2 results

  • Chapter 13 - Supraglottic Airways

  • from Section 1 - Airway Management: Background and Techniques
  • Edited by Tim Cook, Michael Seltz Kristensen
  • Book:
    Core Topics in Airway Management
    Published online:
    03 October 2020
    Print publication:
    03 December 2020, pp 102-121

  • Summary

    Supraglottic airways (SGAs) have been part of core anaesthetic practice for approximately 30 years, since the introduction of the classic laryngeal mask which is described in some detail. In many countries an SGA is now used for airway management for the majority of anaesthetics. Optimal use and insertion technique are described. The range of SGAs available and their roles have expanded dramatically in this time. Second generation SGAs are those designed to reduce the risk of aspiration and are emphasised in this chapter. With the wide range of SGAs available it can be problematic to decide which device to use and this is especially so as the boundaries of acceptable use are ever widened. This chapter describes those devices with the greatest versatility and utility – arguably also with the greatest safety profile too – and some newer devices. SGAs have a major role to play in advanced and difficult airway management. The use of an SGA as a rescue device and as a conduit for intubation during management of the difficult airway is described in detail.

  • Comparison of tracheal intubation and alternative airway techniques performed in the prehospital setting by paramedics: a systematic review

  • Jan L. Jensen, Ka Wai Cheung, John M. Tallon, Andrew H. Travers
  • Journal:
    Canadian Journal of Emergency Medicine / Volume 12 / Issue 2 / March 2010
    Published online by Cambridge University Press:
    21 May 2015, pp. 135-140
    Print publication:
    March 2010
    • Article
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  • This systematic review included controlled clinical trials comparing tracheal intubation (TI) with alternative airway techniques (AAT) (bag-mask ventilation and use of extraglottic devices) performed by paramedics in the prehospital setting. A priori outcomes to be assessed were survival, neurologic outcome, airway management success rates and complications. We identified trials using EMBASE, MEDLINE, CINAHL, The Cochrane Library, Web of Science, author contacts and hand searching. We included 5 trials enrolling a total of 1559 patients. No individual study showed any statistical difference in outcomes between the TI and AAT groups. Because of study heterogeneity, we did not pool the data. This is the most comprehensive review to date on paramedic trials. Owing to the heterogeneity of prehospital systems, administrators of each system must individually consider their airway management protocols.