Laryngeal mask airway control versus endotracheal intubation by medical personnel wearing protective gear

The purpose of this study was to evaluate the rates of successful airway control using endotracheal tubes (ETs) or laryngeal mask airways (LMAs) and compare them between anesthetists and non-anesthetists wearing full antichemical protective gear. Anesthetists and non-anesthetists (n = 10 per group) twice attempted inserting ETs and LMAs on a mannequin model of airway management in a crossover, prospective manner. Times to successful insertion and failure rates were recorded. Non-anesthetists had a slightly higher failure rate inserting ETs compared with anesthetists (P = not significant). Respective mean times to successfully inserting ETs were 38 ± 7.1 and 26.4 ± 7.5 seconds (P < .05). Both groups inserted LMAs more rapidly than ETs (P < .05) and their failure rates in ET use were higher. In view of the relative rapidity by which LMAs were inserted as compared with ETs, by fully protected caregivers, the incorporation of LMA in algorithms dealing with emergency airway management in a nonconventional mass casualty scenario deserves further evaluation.