King airway
INDICATIONS:
- Cardiac arrest / Resp. arrest (unconscious, no gag reflex, apnea or reps <6/minute)
- Hypoxia and/or hypoventilation refractory to non-invasive airway/respiratory management
- Airway protection to reduce aspiration for sustained ALOC with Glasgow < 8
- Appears at least 4’ tall, King #3 is for small adults down to 4 feet tall
CONTRAINDICATIONS:
- Patient under 4 feet tall
- Responsive patients with an intact gag reflex
- Patients with known esophageal disease
- Patients who have ingested caustic substances
- Known narcotic OD
- Laryngectomy patient with stoma
- Airway obstruction
- King airway will not advance due to resistance
COMMENTS:
May be continued during CPR, 3 attempts max, ventilation between each attempt, each attempt no longer than 30 seconds, one attempt per minute cycle of CPR, use ETCO2 for perfusing rhythms.
EQUIPMENT:
- King Airway
- ETCO2 device (use for pts. with perfusing rhythms)
- 140 ml and 20 mL syringes
- ET holder
- Suction catheter
- Oxygen
- BVM
- Stethoscope
PROCEDURE:
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Choose correct King based on size of patient:
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#3 - 4-5 ft tall
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#4 - 5-6 ft tall
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#5 - 6+ ft tall
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Test cuffs (#3 - 60 mL / #4 - 80 mL / #5 - 90 mL)
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Ventilate pt. with 100% O2 prior to insertion.
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Place head in neutral position “Sniffing position”
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Grasp lower jaw with thumb and index finger and lift.
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Hold King Airway in other hand with curvature in same direction as natural curvature of the pharynx.
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Blindly insert tube gently into mouth & advance tube until base of connector is aligned with teeth or gums.
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Do not force the tube. If the tube doesn’t advance easily, redirect it or withdraw and reinsert.
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Inflate cuff according to volume noted on tube
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Ventilate and confirm placement with auscultation and End Tidal CO2 monitoring.