FastrachTM laryngeal mask for out-of-hospital airway management in critical patients

Chayán Zas ML, Iglesias Vázquez JA, Chayán Zas A, Faraldo Balado V, Barreiro Díaz MV, Cegarra García M

Objective: To describe the epidemiologic profile of intubations performed with the

Fastrach® laryngeal mask and analyze the utility of this mask in critically ill patients

attended out of hospital by US-061 ambulance crews.

Material and methods: Retrospective, observational, descriptive study of the period

January 2002 through December 2007. Seventy-three patients attended by US-061

crews required airway management with the Fastrach® mask. Data were extracted from

computerized medical records. Variables analyzed were age, sex, medical event or

trauma, initial cardiac rhythm, survival until arrival at the hospital, and percentage of

patients requiring airway management in whom the mask was used.

Results: A total of 4112 patients required airway management. The Fastrach® laryngeal

mask was used in 73 (1.8%) (11.1% women). The mean (SD) age of these patients was

50.7 (5) years. Four of the 73 patients (5.5%) could not be intubated with the Fastrach®

mask. Intubation was required for medical reasons in 35 (48%) and for trauma in 38

(52%). Twenty-five (71.4%) of the medical patients and 10 (26.3%) of the trauma

patients were initially in cardiac arrest. Eighteen medical patients (51.5%) and 24

(63.2%) trauma patients were alive on arrival at the hospital.

Conclusions: Although the outcome of orotracheal intubation is generally good, the

airway cannot be managed with this procedure in a small percentage of patients.

Therefore, the Fastrach® laryngeal mask provides a second-line option. It is easy to use,

facilitating airway management in situations that may be difficult for intrinsic or extrinsic

reasons.

Barreiro Díaz MV, Cegarra García M, Chayán Zas A, Chayán Zas ML, Faraldo Balado V, Iglesias Vázquez JA