1. Self-learning Module Practical Review
King LTS-D Airway
Self-learning Module
Practical Review
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Objectives
Identify anatomy of the upper airway.
Describe current artificial airways.
Describe the indications and contraindications for the placement of the King LTS- D airway (KLTS-D).
Describe the correct placement of the KLTS-D.
Describe MIEMSS Laryngeal Tube Airway Device protocol.
Demonstrate the correct placement of the KLTS-D.
Demonstrate troubleshooting techniques
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Contents
Section 1 – Upper Airway Anatomy & Artificial Airway Options Review
Section 2 – King LTS-D introduction/use.
Section 3 – MIEMSS protocol review
Section 4 – Post Test
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Instructions
Review power point, click on and read/view all links.
Record answers to post-test questions at end of Self-Learning Module on separate Post-test and Practical Experience Confirmation form.
Take form with recorded answers to evaluator; perform practical experience with evaluator.
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5. Review of Artificial Airway Options
SECTION 1
Upper Airway Anatomy
&
Review of Artificial Airway Options
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Upper Airway Anatomy
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7. Common Non-surgical Artificial Airways
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8. Oral Airway Nasal Airway
Oral airway placed into the oropharynx
Nasal Airway placed into the nasopharynx
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Combitube
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10. Endotracheal intubation
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11. LMA-Laryngeal Mask Airway
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King LTS-D
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Section 2
King LTS-D
Introduction
Placement
Use
Contraindications/Warnings
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14. King LTS-D Description
King LTS-D consists of a curved double-lumen tube with separate pathways for ventilation/access to stomach
Ventilation lumen-
ends between two inflatable cuffs with a variety of openings to align with the laryngeal inlet
Has a 15 mm connector for attachment to resuscitation bag or ventilator circuit
Gastric lumen-
Separate conduit which will allow passage of up to 18 Fr standard gastric tube
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15. King LTS-D Indications for use
This device (per MIEMSS protocols) is intended for:
Patients requiring an artificial airway who have failed direct laryngoscopy without a gag reflex
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King LTS-D Benefits
Latex Free
Provides the ability to provide positive pressure ventilation as well as allowing spontaneous breathing
Seal Pressure > 30 cm H20
Ease of Insertion
Low incidence of sore throat/trauma
Minimizes gastric insufflation
Allows for easy passing of a gastric tube via the gastric access lumen
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17. King LTS-D Warnings/Precautions
Not proven to protect the airway from the effects of regurgitation/aspiration
High airway pressures may divert gas to the atmosphere
Intubation of the trachea cannot be ruled out as a potential complication
After placement, perform standard checks for breath sounds/utilize appropriate CO2
Lubricate only the posterior surface of the King LTS-D to avoid blockage of the ventilation apertures or aspiration of lubricant
Single use only
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18. King LTS-D Contraindications
Responsive patients with an intact gag reflex
Patients with known esophageal disease
Patients who have ingested caustic substances
Patients < 35 inches (per MIEMSS protocols)
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King LTS-D Research
Click links to read articles
Manufacturer Instructions Link:
Videos:
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King LTS-D Insertion
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28. King LTS-D Additionally
Insertion of a nasogastric tube (up to 18 Fr) thru the proximal opening of gastric access lumen will:
Ensure proper placement
Allow stomach to decompress
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29. Section 3 – MIEMSS optional protocol review
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Post – Test questions
Place the answers to the following questions on the separate Post – Test and Practical Experience Verification form.
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1.The proper size King LTS-D tube for a 5’8” patient is :
a. 3
b. 4
c. 5
d. 6
2.When initially inserting the LTS-D into the mouth the blue orientation line should be facing the patient’s_________ .
a. chin
b. corner of mouth
c. septum
d. tongue
3. The proper size King LTS-D tube for a 6’2” patient is :
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4. An 18 Fr or smaller NG tube can be placed thru the proximal gastric opening of the LTS-D tube into the esophagus and stomach?
a. TRUE
b. FALSE
5. After insertion of the LTS-D tube and inflation of the cuffs, withdrawing the tube slightly while ventilating may be required to achieve better ventilation.
6.In Maryland, a size 2 or 2.5 LTS-D tube can be used for a pediatric patient according to their height.
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7. Heavy insertion force is sometimes required to get the LTS-D tube into proper position prior to inflating the cuffs :
a. TRUE
b. FALSE
8. The proper cuff inflation volume for a 4’6” patient should be about :
a. 60 ml
b. 70 ml
c. 80 ml
d. 90 ml
9. The King LT-D and the King LTS-D are essentially the same and either can be used in Maryland :
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10. The blue orientation line of the tube should be rotated to face the patient’s chin after the distal tip of the tube passes _______ .
a. the teeth
b. into the esophagus
c. the base of the tongue
d. the epiglottis
POST TEST COMPLETE
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Conclusion
Please turn in your answers to an approved evaluator and complete the practical experience to finalize this training.
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