1. Airway management

2. SIZES YELLOW 4-5 ft Balloon filled 45-60cc RED 5-6 ft Balloon filled 60-80 cc Purple greater than 6 ft Balloon filled 70-90cc

3. INDICATIONS BLS Airway Unconscious patient with unprotected airway and no gag reflex Failed ALS airway

4. CONTRAINDICATIONS Intact gag reflex Known esophageal disease Ingestion of caustic substance

5. INSERTION Choose correct size based on patient height Test cuff for air leaks Apply lubricant to distal tip

14. Insertion video http://www.youtube.com/watch?v=ca710sG4-ck

15. ASSESS PLACEMENT Attach BVM and ventilate Listen to BS bilaterally Utilize Capnography

16. REMOVAL OF KING COMBITUBE INDICATIONS Return of gag reflex

17. PROCEDURE Turn on suction unit Deflate balloon Turn patient on side and be prepared to suction Remove KING tube and suction as necessary

18. REMOVAL BY PM OR MD Per Snohomish County Protocol 11-10 “A paramedic or physician may choose to remove the device to replace it with and endotracheal tube. The patient’s airway is your responsibility until you educate higher level medical personnel to the specifics of the device, and said medical personnel make an informed decision to remove the device.”