Loudoun County EMS Council, IncALS Committee

Revised 11/20131

King LT-D Airway Program

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 11/20132

Five Sizes

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

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

• Oral airway

• Tape

• Water-based lubricant

• Stethoscope

Revised 11/20134

Need Picture

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 11/20135

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 11/20136

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 11/20137

King Airway Insertion 1 of 7

Revised 11/20138

Prepare

Your

Equipment

King Airway Insertion 2 of 7

Check tube and balloonLubricate back of tube only

Revised 11/20139

King Airway Insertion 3 of 7

• 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 (tongue-

jaw-lift)• Hold the King Airway at the connector

area as you would a pencil

Revised 11/201310

INSERTION

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 11/201311

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 11/201312

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

Revised 11/201313

CONFIRMATION

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 11/201314

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 11/201315

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

REVIEWQUESTIONS

Revised 11/2013

17

In Loudoun County, you have standing orders to use the King Airway on patients that are ________ .

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Pulseless and Apneic

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 11/201319

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 11/201320

When using the King Airway, inflate Size 2

(Green) with __ to __ cc of air.

Green 25-35 cc

Revised 11/201321

The Cuff (Balloon) should be inflated after assuring chest

rise?TRUE or FALSE

Revised 11/201322

False

If you do not get chest rise when first ventilating the King Airway, you should _______ .

Slightly pull it back and attempt to ventilate

Revised 11/201323

You should secure the King Airway in place

using __________.CollarTape

Bite BlockRevised 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

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26

The EDD (Esophageal Detector Device) should be used to check King Airway placement.

TRUE / FALSE

Revised 11/201327

False

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

Revised 11/2013

29

True