EMT-P CL Protocols King Airway

positive pressure ventilation

larger sizes (3, 4, 5) allow ability to pass a gastric tube through the second channel of the airway and into the esophagus and stomach

-pass a gastric tube up to 18 french

-channel for regurgitation which reduces potential for regurgitation to get past the cuff and aids in reducing emesis aspiration

-provides "vent" for gastric pressure and stomach decompression

1) acute airway compromise where ET intubation is not possible/available

2) ET intubation cannot be accomplished (anatomical difficulty or cords cannot be visuaed due to bleeding or vomit

1) patients with an intact gag reflex

2) pt with known esophageal disease

3) pt who have ingested caustic substances

4) pt less then 35 inches tall

standing order EMT I & P

1) Preoxygenate for 1-2 min with high flow

2) choose correct size

3) prepare airway (test for leaks/lubricate)

4) grab tongue and jaw and pull forward

5) rotate airway 45-90 degrees, blue line touches corner of the mouth

6) as tip passes tongue, rotate back to midline

7) advance tube until base of connector is aligned with teeth or gums

8) inflate cuff to appropriate volume

9) conect airway to BVM

10) confirmation primary and secondary, must be charted

-do not force airway, withdraw and reinsert if resistence felt

-placement of the king airway should be completed within 30 seconds

2 (35-45inches) 25-35 cuff volume
2.5 (41-51inches) 30-40
3 (4-5ft) 60
4 (5-6ft) 80
5 (6+ft) 90