Airway management training using the laryngeal mask airway: a comparison of two different training programmes.

Nurses without prior experience in the use of the laryngeal mask airway (LMA) were randomly allocated to one of two groups to be trained in the emergency technique of insertion of an LMA. Group A (32 nurses) were trained only on a manikin and group B (20 nurses) were trained on a manikin and with live anaesthetised patient practice in theatre (five successful insertions). Without further practice, both groups were asked to insert an LMA in a live patient in theatre 3 months after initial training. Three attempts per nurse were allowed. In group A, 75% passed the LMA successfully at the first attempt, 22% at the second attempt and 3% (one nurse) at the third attempt. In group B, 80% were successful at first attempt and 20% at the second attempt. Skill performance and retention were shown to be high following either training method, with no significant difference between the performance of either group (chi 2). We have shown that manikin-only training in the emergency technique for LMA insertion is as effective as live patient training. It is proposed that manikin training alone may be adopted as a future training modality if, as is expected, the use of the LMA in resuscitation becomes more commonplace.

The laryngeal mask: an essential part of emergency airway management.

In this article I have endeavoured to introduce the laryngeal mask airway to those who have not come in contact with it in their clinical experience. Those who have and want to know more will, after reading it, form a knowledge base which, I hope, will encourage the acquisition of the skill of insertion. The background and development of the mask are described along with a description of the mask's insertion into the airway and its positioning. I have also included our experience gained whilst introducing the mask into our Hospital Trust, the Royal Berkshire & Battle Hospital NHS Trust (UK), and the training programme which we set up to train an retrain necessary personnel. The aim of the article is not to usurp the endotracheal tube's position in emergency airway management, but to enlighten the reader as to how the mask can dovetail in with its use. The endotracheal tube, of course, remains the gold standard in the isolation of the adult patient's airway in cardiopulmonary arrest.

Introducing nurse-initiated management of cardiac arrest.

Extending practice has been a matter of debate for nurses. This article describes an initiative to extend nursing practice safely at a local level, in response to changes in service provision. The author describes the benefits that training in life support techniques has had for nurses involved in the management of cardiac arrest.