Larynxmask eller endotrachealtub prehospitalt ? styrkor och svagheter
Litteraturstudie
ABSTRACTBackgroundWhen faced with an unexpected cardiac arrest the ambulance nurse is in responsible for taking advanced actions to create a clear airway. Two accepted methods for this is endotracheal intubation and application of laryngeal mask.AimThe purpose of this study was to examine the use of endotracheal intubation compared to application of the laryngeal mask in unexpected cardiac arrest.MethodLiterature study with quantitative approach. A systematic search of 21 articles comparing the laryngeal mask with the endotracheal intubation has been made using Pub-Med and CINAHL. A quality review according to Forsberg and Wengström has been made.ResultsLaryngeal mask had a higher rate of successful applications compared with endotracheal intubation. Time for applying the laryngeal mask was shorter in seven out of ten of the studied articles. Survival after application indicated that the endotracheal tube was associated with increased survival compared with the laryngeal mask in two of the five studied articles. In the remaining articles, no significant differences were seen. The laryngeal mask did not show any difference in air leakage and it could not be displaced from the position to a greater extent than the endotracheal tube when exposed to the same force.ConclusionCompared with endotracheal intubation the laryngeal mask had a higher rate of successful applications and faster time to established airway when used by prehospital personnel. Patients cared for by endotracheal intubation, were however, associated with increased survival after unexpected cardiac arrest.KeywordsEndotracheal tube, laryngeal mask, prehospital, ambulance nurse, nursing.