Maryland ExpressCare_20091 King LTS-D Airway Self-learning Module Practical Review

Maryland ExpressCare_2009 1

King LTS-D Airway

Self-learning ModulePractical Review


Objectives

Identify anatomy of the upper airway. Describe current artificial airways. Describe the indications and contraindications for the

placement of the King LTS- D airway (KLTS-D). Describe the correct placement of the KLTS-D. Describe MIEMSS Laryngeal Tube Airway Device protocol. Demonstrate the correct placement of the KLTS-D. Demonstrate troubleshooting techniques


Contents

Section 1 – Upper Airway Anatomy & Artificial Airway Options Review

Section 2 – King LTS-D introduction/use. Section 3 – MIEMSS protocol review Section 4 – Post Test


Instructions

Review power point, click on and read/view all links.

Record answers to post-test questions at end of Self-Learning Module on separate Post-test and Practical Experience Confirmation form.

Take form with recorded answers to evaluator; perform practical experience with evaluator.


SECTION 1

Upper Airway Anatomy

&

Review of Artificial Airway Options


Upper Airway Anatomy


Common Non-surgical Artificial Airways


Oral airway placed into the oropharynx

Nasal Airway placed into the nasopharynx

Oral AirwayNasal Airway


Combitube


Endotracheal intubation


LMA-Laryngeal Mask Airway


King LTS-D


Section 2

King LTS-D

IntroductionPlacementUseContraindications/Warnings


King LTS-D consists of a curved double-lumen tube with separate pathways for ventilation/access to stomach

Ventilation lumen-ends between two inflatable cuffs with a variety of openings to align with the laryngeal inletHas a 15 mm connector for attachment to resuscitation bag or ventilator circuit

Gastric lumen-Separate conduit which will allow passage of up to 18 Fr standard gastric tube

King LTS-DDescription


King LTS-DIndications for use

This device (per MIEMSS protocols) is intended for: Patients requiring an artificial airway who

have failed direct laryngoscopy without a gag reflex


King LTS-DBenefits

Latex Free Provides the ability to provide positive pressure

ventilation as well as allowing spontaneous breathing

Seal Pressure > 30 cm H20 Ease of Insertion Low incidence of sore throat/trauma Minimizes gastric insufflation Allows for easy passing of a gastric tube via the

gastric access lumen


King LTS-DWarnings/Precautions

Not proven to protect the airway from the effects of regurgitation/aspiration

High airway pressures may divert gas to the atmosphere

Intubation of the trachea cannot be ruled out as a potential complication

After placement, perform standard checks for breath sounds/utilize appropriate CO2

Lubricate only the posterior surface of the King LTS-D to avoid blockage of the ventilation apertures or aspiration of lubricant

Single use only


King LTS-DContraindications

Responsive patients with an intact gag reflex

Patients with known esophageal disease Patients who have ingested caustic

substances Patients < 35 inches (per MIEMSS

protocols)




King LTS-DResearch

Click links to read articles http://www.emsresponder.com/print/EMS-Magazine/Prehospital-Pediatric-Airway-Management/

1$8905

http://www.kingsystems.com/Portals/1/The%20use%20of%20the%20laryngeal%20tube%20by%20nurses%20in%20out%20of%20hospital.pdf

http://www.kingsystems.com/Portals/1/Guyette,%20KING%20Airway%20Use%20by%20Air%20Medical%20Providers.pdf

http://www.kingsystems.com/Portals/1/Airway%20management%20in%20cardiac%20arrest.pdf http://www.kingsystems.com/Portals/1/A%20new%20adjunct.pdf http://www.jems.com/news_and_articles/columns/Wesley/

Three_Airway_Modalities_in_Difficult_Airways.html#

Manufacturer Instructions Link: http://www.kingsystems.com/Portals/1/KING%20LT(S)D%20IFU%200608.pdf

Videos: http://www.kingsystems.com/portals/1/king%20lt%20web.wmv http://www.youtube.com/watch?v=ryyHWewl5ho


King LTS-DInsertion







King LTS-DAdditionally

Insertion of a nasogastric tube (up to 18 Fr) thru the proximal opening of gastric access lumen will: Ensure proper placement Allow stomach to decompress


Section 3 – MIEMSS optional protocol review





Post – Test questions

Place the answers to the following questions on the separate Post – Test and Practical Experience Verification form.


1.The proper size King LTS-D tube for a 5’8” patient is :a. 3b. 4c. 5d. 6

2.When initially inserting the LTS-D into the mouth the blue orientation line should be facing the patient’s_________ .

a. chinb. corner of mouthc. septumd. tongue

3. The proper size King LTS-D tube for a 6’2” patient is :a. 3b. 4c. 5d. 6


4. An 18 Fr or smaller NG tube can be placed thru the proximal gastric opening of the LTS-D tube into the esophagus and stomach?

a. TRUEb. FALSE

5. After insertion of the LTS-D tube and inflation of the cuffs, withdrawing the tube slightly while ventilating may be required to achieve better ventilation.

a. TRUEb. FALSE

6.In Maryland, a size 2 or 2.5 LTS-D tube can be used for a pediatric patient according to their height.

a. TRUEb. FALSE


7. Heavy insertion force is sometimes required to get the LTS-D tube into proper position prior to inflating the cuffs :

a. TRUEb. FALSE

8. The proper cuff inflation volume for a 4’6” patient should be about :

a. 60 mlb. 70 mlc. 80 mld. 90 ml

9. The King LT-D and the King LTS-D are essentially the same and either can be used in Maryland :

a. TRUEb. FALSE


10. The blue orientation line of the tube should be rotated to face the patient’s chin after the distal tip of the tube passes _______ .

a. the teethb. into the esophagusc. the base of the tongued. the epiglottis

POST TEST COMPLETE


Conclusion

Please turn in your answers to an approved evaluator and complete the practical experience to finalize this training.

Documents

Maryland ExpressCare_20091 King LTS-D Airway Self-learning Module Practical Review