King LTS-D Airway

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King LTS-D Airway

• Self-learning Module
• Practical Review

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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

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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

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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.

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SECTION 1

• Upper Airway Anatomy
• Review of Artificial Airway Options

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Upper Airway Anatomy
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• Common Non-surgical Artificial Airways

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Oral AirwayNasal Airway

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

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• Combitube

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• Endotracheal intubation

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• LMA-Laryngeal Mask Airway

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• King LTS-D

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Section 2

• King LTS-D
• Introduction
• Placement
• Use
• Contraindications/Warnings

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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

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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

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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

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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

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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)

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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

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King LTS-D Insertion
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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

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Section 3 MIEMSS optional protocol review
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Post Test questions

• Place the answers to the following questions on
  the separate Post Test and Practical Experience
  Verification form.

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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
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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
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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
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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
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Conclusion

• Please turn in your answers to an approved
  evaluator and complete the practical experience
  to finalize this training.