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Annals of Disaster Medicine 
  |   ISSN:1684-193X 
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          Updated 
            
            Jan 18, 2003
            
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          Contents: 
            Volume 
            1, Nomber 2; Jan, 2003 | 
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 Role of Laryngeal Mask Airway in First Aids in Confined 
              Space  |    |  
 Tzong-Luen Wang, MD, PhD, Kuo-Chih Chen, MD, Hsueh-Ju Teng, 
              MD, and Hang Chang, MD, PhD  |    
|   |    Abstract 
              ---Laryngeal mask airway (LMA) has been shown to 
              be an alterative method of definite airway but its role in rescue 
              from confined space has not been determined. One hundred and sixty 
              seven persons who attended the training course of disaster medicine 
              were enrolled as the study population. Sixty two of them were men 
              whereas the other 105 women. Thirty four of the study population 
              were medical doctors, 95 nurses, 30 emergency medical technicians, 
              and 8 laypersons. We arranged a workshop of confined space medicine. 
              The comparison of applicability between conventional endotracheal 
              intubation and LMA was made. Before evaluation, every participant 
              accepted detailed illustration and demonstration of the skills. 
              Every one was asked to perform airway management for the manikins 
              in confined space with face down, sitting position, side position 
              and ˇ§reverseˇ¨ supine position. The success rate and the time elapse 
              for both endotracheal intubation and LMA application/intubation 
              was compared. Success rate of first LMA application is 100% for 
              all positions which is significantly better than those of endotracheal 
              intubation (85% for sitting position, P<0.01; 80% for side position, 
              P<0.01; 76% for face down, P<0.01; and 74% for ˇ§reverseˇ¨ supine 
              position, P<0.001). The time elapse for first LMA application 
              was also significantly lower than those of endotracheal intubation 
              (as presented). The success rate and time elapse of first LMA intubation 
              and the number of trials before success was comparable to endotracheal 
              intubation. LMA was preferred as a choice of airway management in 
              confined space rescue.  |    
          | Key words---Laryngeal Mask Airway; Confined 
            Space; First Aid; Disaster | 
                
  
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