2

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.

3

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.

4

Other Accessories

• Proper BSI

• BVM

• Oral airway

• Tape

• Water-based lubricant

• Stethoscope

Revised 11/12 Loudoun County EMS Council, Inc.

Need Picture

5

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.

6

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.

7

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.

8

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

10

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

12

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.

13

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.

14

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.

15

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.

16

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.

17

REVIEWQUESTIONS

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18

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

19

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

21

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.

23

The King Airway should only be used on patients that are ____

inches or taller.

35

Revised 11/12 Loudoun County EMS Council, Inc.

24

The King Airway should be inserted until __________ .

The teeth or gums are at the base of the connector

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25

The EDD should be used to check King Airway placement.

TRUE / FALSE

Revised 11/12 Loudoun County EMS Council, Inc.

False

26

Which medications could be administered through the King

Airway?

None

Revised 11/12 Loudoun County EMS Council, Inc.

27

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