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:

Choose correct King based on size of patient:
- #3 - 4-5 ft tall
- #4 - 5-6 ft tall
- #5 - 6+ ft tall
Test cuffs (#3 - 60 mL / #4 - 80 mL / #5 - 90 mL)
Ventilate pt. with 100% O2 prior to insertion.
Place head in neutral position “Sniffing position”
Grasp lower jaw with thumb and index finger and lift.
Hold King Airway in other hand with curvature in same direction as natural curvature of the pharynx.
Blindly insert tube gently into mouth & advance tube until base of connector is aligned with teeth or gums.
Do not force the tube. If the tube doesn’t advance easily, redirect it or withdraw and reinsert.
Inflate cuff according to volume noted on tube
Ventilate and confirm placement with auscultation and End Tidal CO2 monitoring.

Link - PR-140