The King LT versus the Combitube: flight crew performance and preference

Air medical personnel frequently face the challenge of the emergency airway. The Combitube is an airway device commonly used by emergency medical services (EMS) providers as either a primary or rescue airway.

We sought to evaluate the performance and preference of air medical personnel using a newer laryngeal tube airway device, the King LT, versus the Combitube in a simulator model.

Participants included flight physicians, nurses, and paramedics in our air medical transport program. Twenty-seven subjects participated. Participants received a 10-minute instructional program, and then had individual practice with each device. Participants were tested on the insertion of each device in a Laerdal SimMan. Rates of successful placement, time to successful placement, and practitioner preference were recorded. Perceived ease of insertion was measured on a five-point scale (1 = easy, 5 = difficult).

All 27 participants correctly placed each device. Mean time to placement was 24.4 seconds (standard deviation [SD] of 4.7 seconds) for the King LT and 37.9 seconds (SD of 5.9 seconds) for the Combitube. The difference in mean times was 13.5 seconds (p < 0.0001). For the participants' perceived ease of insertion, the mean score for the King LT was 1.3 and that for the Combitube was 2.5. Twenty-six of 27 participants preferred the King LT over the Combitube.

The King LT was placed significantly faster than the Combitube and was also perceived as easier to place. Ninety-six percent of the participants preferred the King LT. Limitations include using a simulator model rather than a human model.