King Airway

I am with the McCormick County EMS in South Carolina, where EMT Basic and Intermediates can no longer intibate as of January 1, 2009. Our service just went to the King Airway which seems easy to use. Has anyone out there actually used the King Airway on a patient? If so,what are your thoughts on ising it?

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Permalink Reply by Rick on January 14, 2009 at 12:18pm

In regards to your comment. It is exactly a rescue airway device. It is no different that a combi tube. In fact, it is safer and less to do to obtain the same desired result. IF you have a King LTS-D, you can use the NG port to resolve the issue you state. Both Combi and King have obturator bulbs at the distal end of the tube. There is no difference. The one comment about the Auto pulse and is a rare issue. We have Auto pulse units and have used the King airway with spectacular results. End tidal WNL. SPO2 reading of 100% and NIBP's obtained during operation. The only thing we needed was for the patient to get up and walk into the Medic. I have personally arrived on scenes to find combi tubes with as many if not more issues as the King. NPO or not you still have a slight chance of aspiration with either. Matter of fact I wrote the company and addressed the message to the responsible parties for drafting the SOP or procedure of insertion. The large bulb is directed to be inflated first. My opinion is inflating the esophagus first to block emesis then inflate the pharyngeal bulb. As for your statement of position, We have not seen this issue to date. All have been inflated, occational addition of air. Wave forms good. Even used Paralytics with excellent results. Not saying that there might a patient that could prove to be difficult but thus far we are 100% non issues. Prior to King we also used Combi tubes. I can not say this device was without it's issues. Better than not having a rescue airway device but not a King either.

Cathy Etter said:

It does not protect against aspiration! We stuck with the combi-tube. The King has to be positioned and re-positioned. If you have a patient who is NPO then use it. But in 911 how may patients ar NPO?? Not a real good 911 rescue device. Great for the OR!

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Permalink Reply by Gina on January 29, 2009 at 1:49pm

Ed, I would love to have the video of the King Airway you have, if you could send it my way it would be greatly appreciated. Our department just switched from the Combitube to the King, so anything would be helpful!!!

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Permalink Reply by Dave Long on January 30, 2009 at 3:37pm

Hey All from northern Minnaeapolis
North Memorial Ambulance has switched to the King Airways instead of the Combi tube
Key learning component is when inserting it into the throat in the last skills session was:
1. On insertion do a slight right twist-not much
2. Inflate cuff to 60cc
3. Attach BVM
4. Gently queeze BVM and pull back until first release and deflation of the BVM
5. You have hit the spot, add another 20 cc
6. Verify with auscultation of the epigastrum first, followed by lung sounds
7. ETCO2 numerical value and color wave form (or Easy Cap)
8. Reverify often and every time patient is moved
Dave Long, EMS Educator, NMA Driving Chair, EMSResponder.com contributor

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Permalink Reply by Juan Atan on March 6, 2009 at 8:38pm

IT'S AWESOME!!!!!!
Does the terminology you can teach it to a monkey? Well it's that easy and it's firefighter proof! Hope this helps out.
Juan

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Permalink Reply by Karrie Harless on March 8, 2009 at 8:58pm

I am in Indiana, and EMT Basic aren't allowed to intubate. We can only use the King Airway or a Combi-tube. The state switched to using the King Airway about a year ago. I've only used it once and it was easy. You shouldn't have to much difficulities.

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Permalink Reply by Eric E. Kincaid on March 14, 2009 at 4:35pm

I've used them a few times. The last time was when an MD decided to attempt ETI "10-12 times" without paralytics on a post-code female that had a gag reflex. By the time we got there her airway was swollen badly. I took one look and couldn't ID any landmarks and punted with the King. As another poster stated, educating your receiving hospital staff is important because they tend to freak out if they are not familiar. The first time I was exposed to them was on a pre-hospital rollover in the middle of the night. As I walked up to the patient I saw the tube and thought 2 things: 1, that thing is way to deep and 2. it's full of blood (red plastic top). After a rapid education on the device I was cool with it. The airway itself works wonderfully and I don't replace them with an ET if they are ventilating well. I'm not willing to risk a good temporary airway to exchange it with an ET just to make the receivers feel better.

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Permalink Reply by Delores Johnson on April 14, 2009 at 2:39pm

Please send me the video on the king airway .

Delores

Ed Spa said:

I have a video from the KING Airway if any one wants it. It is to large of a file to post it. Email me and I can send you the file. My email address is on my page.

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Permalink Reply by James Eli Couch on March 24, 2010 at 10:11pm

I agree one hundred percent and just what little experience that I have had with the king tube, I would prefer a quicker airway and less time without compressions over something that is as complicated to look at as it is to use in a fast and stressful situation. You sound to me like someone who has done their homework and I could learn alot from.

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Permalink Reply by James Eli Couch on March 24, 2010 at 10:13pm

My e-mail is couchjames@rocketmail.com

Delores Johnson said:

Please send me the video on the king airway .

Delores

Ed Spa said:
I have a video from the KING Airway if any one wants it. It is to large of a file to post it. Email me and I can send you the file. My email address is on my page.

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Permalink Reply by Monica Denkins on March 31, 2010 at 9:26am

We are using them where I work in Atl, Ga and would love to see the video. I haven't had the opportunity to insert one. Thanks for the information. My email is denkinsm@yahoo.com

Ed Spa said:

I have a video from the KING Airway if any one wants it. It is to large of a file to post it. Email me and I can send you the file. My email address is on my page.

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Permalink Reply by Chris Turner on June 1, 2010 at 12:30pm

As said before the big benefit to the Combi over the king is access to the abd. The King only plugs it up where the combi at least keeps the pressure at bay. Otherwise it's just a new LMA.
That said, I'm glad to see anyone realize that ETT isn't always the gold standard. Good airway mgmt is. I'd be one happy medic to never need to ETT someone because I managed their airway with what everyone else calls a "secondary" device AND I was able to insert them without holding compressions.
I just worked a pedi arrest last week and I am so glad that we had those "secondary" devices available. Yes I did try the ETT once, but when that didn't take, I knew I had another option besides holding compressions another couple minutes to try and try again.

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Permalink Reply by Chris Turner on June 1, 2010 at 12:31pm

Amen.

Cathy Etter said:

It does not protect against aspiration! We stuck with the combi-tube. The King has to be positioned and re-positioned. If you have a patient who is NPO then use it. But in 911 how may patients ar NPO?? Not a real good 911 rescue device. Great for the OR!