Loudoun County EMS Council, Inc
ALS Committee
King LT-D Airway Program
Revised 11/2013
1
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 11/2013
2
Five Sizes
2.0
25ml-35ml
• Height of 35-45 Inches
2.5
4.0
60ml-80ml
• Height of 5-6 Feet
30ml-40ml
• Height of 41-51 Inches
5.0
70ml-90ml
• Height of > 6 Feet
3.0
45ml-60ml
• Height of 4-5 Feet
Colors for the King LTD do not correlate with Broselow colors.
Use the LMA # for the King Airway size.
3
Other Accessories
• Proper BSI
• BVM
Need
Picture
• Oral airway
• Tape
• Water-based lubricant
• Stethoscope
Revised 11/2013
4
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)
• For ALS providers as an alternative if difficulty intubating
• On-Line Medical Control must be obtained for any other
situation
Revised 11/2013
5
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 11/2013
6
Use of the King Airway
• When used in conjunction with AED insertion is
considered following:
• All Shocks Completed
• 3 No Shocks
• Complicated Airway (Med-Control Only)
Revised 11/2013
7
King Airway Insertion 1 of 7
Prepare
Your
Equipment
Revised 11/2013
8
King Airway Insertion 2 of 7
Check tube and balloon
Lubricate back of tube
only
Revised 11/2013
9
King Airway Insertion 3 of 7
INSERTION
• Pre-Oxygenate 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 (tonguejaw-lift)
• Hold the King Airway at the connector
area as you would a pencil
Revised 11/2013
10
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 11/2013
11
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 11/2013
12
King Airway Insertion 6 of 7
CONFIRMATION
• 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
Revised 11/2013
13
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 11/2013
14
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 11/2013
15
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 11/2013
16
REVIEW
QUESTIONS
Revised 11/2013
17
In Loudoun County, you have
standing orders to use the King
Airway on patients that are
________ .
Pulseless and Apneic
Revised 11/2013
18
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
Purple 70-90 cc
Revised 11/2013
19
When using the King Airway,
inflate Size 3 (Yellow) with __ to
__ cc of air and the Size 2.5
(Orange) with __ to __ cc of air.
Yellow 45-60 cc
Orange 30-40 cc
Revised 11/2013
20
When using the King Airway,
inflate Size 2 (Green) with __
to __ cc of air.
Green 25-35 cc
Revised 11/2013
21
The Cuff (Balloon) should be
inflated after assuring chest rise?
TRUE or FALSE
False
Revised 11/2013
22
If you do not get chest rise when
first ventilating the King Airway,
you should _______ .
Slightly pull it back and attempt
to ventilate
Revised 11/2013
23
You should secure the King
Airway in place using
__________.
Collar
Tape
Bite Block
Revised 11/2013
24
The King Airway should only be
used on patients that are ____
inches or taller.
35
Revised 11/2013
25
The King Airway should be
inserted until __________ .
The teeth or gums are at the
base of the connector
Revised 11/2013
26
The EDD (Esophageal Detector
Device) should be used to check
King Airway placement.
TRUE / FALSE
False
Revised 11/2013
27
Which medications can be
administered through the King
Airway?
None
Revised 11/2013
28
When used in conjunction with an
AED, the King Airway should be
inserted after the 3rd shock or 3rd
No Shock during a cardiac arrest.
TRUE / FALSE
True
Revised 11/2013
29