Comparison of prehospital insertion success rates and time to insertion between standard endotracheal intubation and a supraglottic airway

Objective: To compare paramedic insertion success rates and time to insertion between standard ETI and a supraglottc airway device (King LTS-D™) in patients needing advanced airway management. Methods: Between June 2008 and June 2009, consented paramedics from 4 EMS systems performed ETI or placed a King LTS-D according to a predetermined randomization calendar. Data collection occurred following each placement via telephone. Placement success (ability to ventilate to chest rise, absence of gastric sounds, presence of bilateral lung sounds, and when applicable, quantitative end-tidal CO ₂ reading) was compared between treatment groups. Time to ventilation (time from airway device in hand ready to place to time of first successful ventilation) was also compared. Results: A total of 213 patients in need of advanced airway management were treated during the study period, with 9 patients excluded from the analysis. The remaining 204 placements by 110 of the 272 consented paramedics were analyzed (median placements per paramedic = 1; range = 1-7). The overall placement success rate was virtually equal across the two groups (ETI = 80.2%, King LTS-D = 80.5%; p= 0.97). The median time to placement between ETI and the King LTS-D was also not significantly different (ETI = 19.5 s vs. King LTS-D = 20.0 s; z= -0.25; p= 0.80). Conclusion: In this study, no differences in placement success rate or time to insertion were detected between the King LTS-D and ETI.