king lt-d airway
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King LT-D Airway
• It is a supraglottic device
• Also known as a blind insertion Airway Device (BIAD)
• Proximal cuff blocks oropharynx
• Distal cuff blocks esophagus
Revised 11/12 Loudoun County EMS Council, Inc.
Five Sizes
Colors for the King LTD do not correlate with Broselow colors. Use the LMA # for the King Airway size.
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25ml-35ml 2.0
•Height of 35-45 Inches
30ml-40ml2.5
•Height of 41-51 Inches
45ml-60ml3.0
•Height of 4-5 Feet
60ml-80ml4.0• Height of 5-6 Feet
70ml-90ml5.0• Height of > 6 Feet
Revised 11/12 Loudoun County EMS Council, Inc.
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Other Accessories
• Proper BSI
• BVM
• Oral airway
• Tape
• Water-based lubricant
• Stethoscope
Revised 11/12 Loudoun County EMS Council, Inc.
Need Picture
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Standing Orders for King Airway insertion
• When the patient is pulseless and apneic
• When the patient does not have a gag reflex (accepts an oral airway)
• As an alternative to manage a difficult airway or if intubating a patient is unsuccessful
Revised 11/12 Loudoun County EMS Council, Inc.
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Contraindications for the use of the King Airway
– Patient is ALIVE!– Patient is under 35 inches – Patient has a gag reflex– Patient has ingested a caustic substance
Revised 11/12 Loudoun County EMS Council, Inc.
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Use of the King Airway
• When used in conjunction with AED insertion is considered following:– All Shocks Completed– 3 No Shocks
– Complicated Airway (Follow Advanced Airway Protocol)
Revised 11/12 Loudoun County EMS Council, Inc.
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King Airway Insertion 1 of 7
Prepare
Your
Equipment
Revised 11/12 Loudoun County EMS Council, Inc.
King Airway Insertion 2 of 7
Lubricate back of tube only
Revised 11/12 Loudoun County EMS Council, Inc. 9
Check tube and balloon
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King Airway Insertion 3 of 7
• Preoxygenate patient for at least 1 minute• Place patient’s head and neck in a neutral position• Remove Oropharyngeal (O.P.) Airway • Grasp tongue and jaw• Lift the tongue and jaw anteriorly (tongue-jaw-
lift)• Hold the King Airway at the connector area as you
would a pencil
INSERTION
Revised 11/12 Loudoun County EMS Council, Inc.
King Airway Insertion 4 of 7
• Insert the tube with the blue line facing the corner of the mouth
• As the tube passes behind the tongue, continue to insert while rotating tube until blue line is mid line
Revised 11/12 Loudoun County EMS Council, Inc. 11
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King Airway Insertion 5 of 7
• Insert the tube until the
base of the connector is at
the level of the teeth or
gums.
• Inflate balloon with the
appropriate amount of air
based on size used.
Revised 11/12 Loudoun County EMS Council, Inc.
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King Airway Insertion 6 of 7
• Attach a BVM to the KING Airway and while bagging the patient, gently withdraw the tube until ventilation becomes easy and free flowing
• Confirm chest rise and lung sounds• Capnography may be used to confirm placement
CONFIRMATION
Revised 11/12 Loudoun County EMS Council, Inc.
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King Airway Insertion 7 of 7
Securing the Device• After placement has been
verified (to include breath sounds)
• Insert an oral airway to prevent the patient from biting the tube.
• Secure the tube using tape and C-collar.
Revised 11/12 Loudoun County EMS Council, Inc.
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When to remove the King Airway
• The King Airway should only be removed if patient regains a gag reflex and begins to “fight” (reject) the tube
Revised 11/12 Loudoun County EMS Council, Inc.
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How to remove the King Airway
– Make sure suction is available and ready
– Remove tape and airway
– Lay patient on their side
– Deflate cuff
– Slowly remove tube
– Suction patient as needed
Revised 11/12 Loudoun County EMS Council, Inc.
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REVIEWQUESTIONS
Revised 11/12 Loudoun County EMS Council, Inc.
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In Loudoun County, you have standing orders to use the King
Airway on patients that are ________ .
Revised 11/12 Loudoun County EMS Council, Inc.
Pulseless and Apneic
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When using the King Airway, inflate Size 4 (Red) with __ to __ cc of air and the Size 5 (Purple)
with __ to __ cc of air.
Red 60-80 cc
Blue 70-90 cc
Revised 11/12 Loudoun County EMS Council, Inc.
20
The Cuff (Balloon) should be inflated after assuring chest rise?
TRUE or FALSE
Revised 11/12 Loudoun County EMS Council, Inc.
False
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If you do not get chest rise when first ventilating the King Airway,
you should _______ .
Slightly pull it back and attempt to ventilate
Revised 11/12 Loudoun County EMS Council, Inc.
22
You should secure the King Airway in place using
__________.CollarTape
Bite Block
Revised 11/12 Loudoun County EMS Council, Inc.
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The King Airway should only be used on patients that are ____
inches or taller.
35
Revised 11/12 Loudoun County EMS Council, Inc.
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The King Airway should be inserted until __________ .
The teeth or gums are at the base of the connector
Revised 11/12 Loudoun County EMS Council, Inc.
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The EDD should be used to check King Airway placement.
TRUE / FALSE
Revised 11/12 Loudoun County EMS Council, Inc.
False
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Which medications could be administered through the King
Airway?
None
Revised 11/12 Loudoun County EMS Council, Inc.
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When used in conjunction with an AED, the King Airway should
be inserted after the 3rd shock during a cardiac arrest.
TRUE / FALSE
Revised 11/12 Loudoun County EMS Council, Inc.
True
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