Indications
a. Inadequate oxygenation &/or ventilation
b. Need to provide airway protection in an obtunded patient without an active gag reflex
c. Inability or unable to perform endotracheal intubation
Contraindications
a. Patients who are conscious or have an intact gag reflex
b. Patients with known esophageal pathology or ingestion of caustic substances
Insertion technique
a. Test cuff inflation by injecting the maximum recommended volume of air into cuffs. Remove all air from both cuffs prior to insertion.
b. Apply a water-based lubricant to the beveled distal tip and posterior aspect of the tube, taking care to avoid introduction of lubricant in or near the ventilatory openings.
c. Pre-oxygenate the patient.
d. Position the patient’s head. The ideal head position for the insertion of the KING LTS-D is the “sniffing” position. However, the angle and shortness of the tube also allows it to be inserted with the head in a neutral position.
e. Hold the KING LTS-D at the connector with dominate hand. With non-dominate hand, hold mouth open and apply chin lift.
f. With the KING LTS-D rotated laterally such that the blue orientation line is touching the corner of the mouth, introduce tip into mouth and advance behind base of tongue. Never force the tube into position.
g. As tube tip passes under tongue, rotate tube back to midline (blue orientation line faces chin).
h. Without exerting excessive force, advance KING-LTS-D until proximal opening of gastric access lumen is aligned with teeth or gums.
i. Inflate cuffs with the minimum volume necessary to seal the airway.
j. Attach the BVM and, while gently bagging the patient to assess ventilation, simultaneously pull back the KING LTS-D device until ventilations go in with ease.
k. Confirm proper position by auscultation, chest movement, and verification of CO2 by capnography.
l. Secure KING LTS-D to patient using an approved commercial device or by tape. A bite block can also be used, if desired.