Comparison of the endotracheal tube and laryngeal mask in airway management by paramedical personnel.

An evaluation of the laryngeal mask airway (LMA) as a means of airway support when used by paramedical personnel was performed. Forty medical and paramedical students attempted to intubate the tracheas of 40 healthy anesthetized adults with the LMA and a cuffed endotracheal tube (ETT). The number of attempts to achieve correct placement and the time taken to adequately ventilate the lungs were recorded for both devices. End-tidal carbon dioxide was detected significantly sooner after commencement of the intubation attempt using the LMA (mean 38.6 s) compared with the ETT (mean 88.3 s, P less than 0.0001). Ninety-four percent of the students successfully ventilated the lungs on their first attempt with the LMA, whereas only 69% intubated the trachea on their first attempt with the ETT (P less than 0.01). Five students were unable to intubate the trachea after three attempts with the ETT, but all positioned the LMA satisfactorily on their first try in a mean time of 40 s. We conclude that unskilled operators with minimal training can safely and successfully ventilate unconscious patients more rapidly using the LMA than the ETT. These results suggest the LMA should be available in all areas where resuscitation is performed.