Prolonged Use of an Extraglottic Airway During Air Medical Transport From a Remote Alaskan Island

Extraglottic devices (EGDs) are important tools for airway management in the prehospital and transport medicine environment. EGDs may be used as either a primary airway or rescue device depending on the provider skill level or patient circumstances. Although EGDs do not provide a definitive airway, they can facilitate oxygenation and ventilation in select patients. This is particularly important in the remote or austere environment when difficult airways are infrequently encountered. This case report details the prolonged use of an EGD during air medical transport from a rural Alaskan medical clinic to a large academic tertiary receiving facility, with the total time until definitive airway placement of approximately 9 hours. We review the prehospital coordination and evaluation, in-flight management, and successful transfer of care of the patient to the receiving tertiary center for definitive intervention.