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34.0 King Airway

EMT

The King LT airway is to be utilized as an adjunct to providing ventilation to a patient with respiratory arrest. The King LT airway replaces the CombiTube airway. The user must be trained in its use

  • Indications
    • Ventilation with a BVM (with OPA/NPA in place) is inadequate
    • Endotracheal intubation is unsuccessful or unavailable.
    • Patient is over 4 feet in height
    • Other means to secure an airway have been unsuccessful or inadequate
  • CONTRAINDICATIONS
    • Patients under 4 feet in height
  • Warnings and Notes
    • The King LT airway does not protect the airway from aspiration like ET intubation does
    • Lube only the beveled distal tip and posterior surface of the King LT to avoid blockage of the aperture or aspiration of lubricant.
  • Procedure
    • Inspect the King LT for visible damage prior to insertion
    • Choose the correct size using the King LT size chart
    • Test the cuff inflation system to ensure it will hold air. Be sure to deflate cuffs before insertion
    • Apply a water-based lubricant to the beveled distal tip and posterior aspect of the tube. Avoid getting lubricant near the ventilatory openings
    • Position the head. The ideal head position for King LT insertion is “sniffing position”. The angle of the King LT does allow for insertion at a neutral angle if necessary.
    • With the King LT rotated laterally 45-90 deg., introduce tip into mouth and advance behind base of the tongue.
    • Rotate the tube back to the midline as the tip reaches the posterior wall of the pharynx
    • Without using excessive force, advance the King LT until base of connector is aligned with teeth or gums.
    • Inflate the cuffs with the minimum volume necessary to seal the airway. Typical inflation volumes are as follows:
      • Size 3: 45-60 cc
      • Size 4: 60-80 cc
      • Size 5: 70-90 cc
    • Ventilate the patient using a BVM or ventilator
    • Assess lung sounds, chest rise and pulse oximetry to ensure adequate ventilations
    • Secure King LT to patient utilizing tape or appropriate commercial device
  • Removal
    • Have suction ready. Suction oral cavity before removal if indicated.
    • FULLY deflate both cuffs before removal of the King LT.
    • Carefully avoid the teeth while removing
    • Remove in the same fashion as an OPA or ET tube
    • Watch for airway swelling post-removal
  • King LT Sizes:
    • Size 3: 4-5 feet in height Yellow Connector
    • Size 4: 5-6 feet in height Red Connector
    • Size 5: 6+ feet in height Purple Connector