Comparison of Standard Method and Triple Airway Maneuver on LMA Insertion Times in Prehospital Cardiac Arrest...

In this study, we hypothesized that in prehospital ambulance environments, the use of the triple airway maneuver-which facilitates airway patency in the mannequin-may allow for faster and easier placement of the Laryngeal Mask Airway (LMA). This study aimed to evaluate the effect of the triple airway maneuver on the LMA insertion times of paramedics with and without chest compression.

This study was designed as a randomized, prospective, crossover simulated manikin study. Paramedics who were working in the Prehospital Command and Control Center were informed about the study. A randomized, crossover study design was used to reduce the learning curve of the participants. For each participant, four scenarios were created in a randomized order: 1) standard method with chest compressions, 2) triple airway maneuver with chest compressions, 3) standard method without chest compressions, and 4) triple airway maneuver without chest compressions. The study was carried out in a moving ambulance in an empty area. The standard method was defined as passive manual support of the head from below. For the triple airway maneuver, an emergency medicine specialist served as the second operator. The LMA application time was defined as the time until the LMA was held, and effective ventilation was provided. The primary outcome of the study was defined as the comparison of LMA insertion times of the standard method and triple airway maneuver for each method.

Twenty-eight participants were included in the study. When all scenarios were compared LMA insertion times did not differ between triple airway maneuver and standard method groups (p = 0.730). During chest compressions, no statistically significant difference was found between the LMA insertion times (mean difference: 0.57 s, 95% CI: -0.819 to 1.961; p = 0.406). Similarly, when chest compressions were not applied, no significant difference was observed between the groups (mean difference: 0.5001 s, 95% CI: -2.00 to 3.50; p = 0.675).

The findings of this study suggest that both the triple airway maneuver and the standard method may be effectively utilized in patients undergoing chest compressions as well as in those without chest compressions.