By Bob Koslow
News-Journal
Copyright 2008 News-Journal
DELTONA, Fla. — Time is life. So when first responders treat patients who can’t breathe, they want the fastest way to push precious oxygen into their lungs.
The traditional method of inserting a shoehorn-looking laryngoscope into the mouth and inserting a tube down the throat, familiar to most TV medical show fans, is still in use. However, some emergency medical crews in Volusia County are trying out a new device that could cut treatment time by more than a minute.
Crews with EVAC ambulance, Deltona and Port Orange fire/rescue departments began a three-month trial evaluation last week of King Systems’ airway devices. Research elsewhere has found the devices to be faster, simpler to use and less intrusive to the patient, said Dr. Peter Springer, Volusia County medical director.
It’s been tested and in use in other places,” he said. “I am not one to change things for the sake of change. I want a valid reason, so we are seeing if the devices will work here.”
Springer convinced King Systems Corp. to donate 120 disposable airway devices. Users will complete a form on the ease of use and report any complications. Springer will decide in early summer if the new ventilation devices become the preferred system for intubating unconscious patients.
The traditional shoehorn device holds back the tongue, tilts the jaw open and takes time to set up, said Assistant Chief Steven Gillespie, Deltona’s medical and training officer.
Only a paramedic can use the laryngoscope. The process requires a view down a patient’s throat to slide a thin tube past the vocal cords and into the smaller passageway — trachea — which leads to the lungs and not down the larger passageway — esophagus — which leads to the stomach.
Pumping air into the stomach can cause a patient to vomit and expands the stomach, making proper chest compressions more difficult on cardiac arrest patients, Deltona engineer firefighter/paramedic Heather Langston said during a recent training session. “It’s a lot more difficult to use than they show on TV,” she said.
In recent years, medical crews have used what is called a combitube to intubate patients. The combitube has two tubes tied together and two balloons to close off the stomach passageway and to hold it in place in the throat.
The King Systems devices use the combitube’s advancements, but make it simpler to use, Gillespie said. “Anything you can do to eliminate steps and provide the same level or greater care is worth doing,” he said.
The King Systems airway device is one tube. The fatteris inserted into the mouth and throat first. It automatically slides into the esophagus and shuts it off.
A small balloon around the tube’s midsection is inflated to hold the device in place and close off the mouth. In between, a vent hole allows for oxygen to be pumped into the lungs.
Paramedics and EMTs can use the King Systems device. That frees up the paramedic to focus on more advanced treatment procedures. The new airway device saves about a minute off the old process and maybe 15 seconds from the combitube, officials said.
The King Systems device comes in several sizes, and an infant size is being developed.
Emergency room doctors and nurses are also being educated on the new devices.
EVAC, being a large countywide service, is frequently evaluating new products, spokesman Mark O’Keefe said. “We had 72,000 calls last year and did 975 intubations. This is a golden opportunity to try new equipment to make sure we are providing the latest care to our residents and visitors,” he said.