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King LTS-D Airway

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Title: King LTS-D Airway


1
King LTS-D Airway
  • Self-learning Module
  • Practical Review

2
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

3
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

4
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.

5
SECTION 1
  • Upper Airway Anatomy
  • Review of Artificial Airway Options

6
Upper Airway Anatomy
7
  • Common Non-surgical Artificial Airways

8

Oral AirwayNasal Airway
  • Oral airway placed into the oropharynx
  • Nasal Airway placed into the nasopharynx

9
  • Combitube

10
  • Endotracheal intubation

11
  • LMA-Laryngeal Mask Airway

12
  • King LTS-D

13
Section 2
  • King LTS-D
  • Introduction
  • Placement
  • Use
  • Contraindications/Warnings

14
King LTS-D Description
  • 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 inlet
  • Has 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

15
King LTS-D Indications for use
  • This device (per MIEMSS protocols) is intended
    for
  • Patients requiring an artificial airway who have
    failed direct laryngoscopy without a gag reflex

16
King LTS-D Benefits
  • Latex Free
  • Provides the ability to provide positive pressure
    ventilation as well as allowing spontaneous
    breathing
  • Seal Pressure gt 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

17
King LTS-D Warnings/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

18
King LTS-D Contraindications
  • Responsive patients with an intact gag reflex
  • Patients with known esophageal disease
  • Patients who have ingested caustic substances
  • Patients lt 35 inches (per MIEMSS protocols)

19

20

21
King LTS-D Research
  • Click links to read articles
  • http//www.emsresponder.com/print/EMS-Magazine/Pre
    hospital-Pediatric-Airway-Management/18905
  • http//www.kingsystems.com/Portals/1/The20use20o
    f20the20laryngeal20tube20by20nurses20in20ou
    t20of20hospital.pdf
  • http//www.kingsystems.com/Portals/1/Guyette,20KI
    NG20Airway20Use20by20Air20Medical20Providers
    .pdf
  • http//www.kingsystems.com/Portals/1/Airway20mana
    gement20in20cardiac20arrest.pdf
  • http//www.kingsystems.com/Portals/1/A20new20adj
    unct.pdf
  • http//www.jems.com/news_and_articles/columns/Wesl
    ey/Three_Airway_Modalities_in_Difficult_Airways.ht
    ml
  • Manufacturer Instructions Link
  • http//www.kingsystems.com/Portals/1/KING20LT(S)D
    20IFU200608.pdf
  • Videos
  • http//www.kingsystems.com/portals/1/king20lt20w
    eb.wmv
  • http//www.youtube.com/watch?vryyHWewl5ho

22
King LTS-D Insertion
23
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28
King LTS-D Additionally
  • 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

29
Section 3 MIEMSS optional protocol review
30
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33
Post Test questions
  • Place the answers to the following questions on
    the separate Post Test and Practical Experience
    Verification form.

34
1.The proper size King LTS-D tube for a 58
patient is a. 3 b. 4 c. 5 d. 6 2.When
initially inserting the LTS-D into the mouth the
blue orientation line should be facing the
patients_________ . a. chin b. corner of
mouth c. septum d. tongue 3. The proper size
King LTS-D tube for a 62 patient is a. 3 b.
4 c. 5 d. 6
35
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. TRUE b.
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. TRUE b.
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. TRUE b. FALSE
36
7. Heavy insertion force is sometimes required to
get the LTS-D tube into proper position prior to
inflating the cuffs a. TRUE b. FALSE 8. The
proper cuff inflation volume for a 46 patient
should be about a. 60 ml b. 70 ml c. 80 ml d.
90 ml 9. The King LT-D and the King LTS-D are
essentially the same and either can be used in
Maryland a. TRUE b. FALSE
37
10. The blue orientation line of the tube should
be rotated to face the patients chin after the
distal tip of the tube passes _______ . a. the
teeth b. into the esophagus c. the base of the
tongue d. the epiglottis POST TEST COMPLETE
38
Conclusion
  • Please turn in your answers to an approved
    evaluator and complete the practical experience
    to finalize this training.
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