International Scholarly Research Network ISRN Emergency Medicine Volume 2012, Article ID 132514, 4 pages doi:10.5402/2012/132514 Research Article Paramedics Manage the Airway Easier with Laryngeal Mask Airway Than with Intubation during Simulated CPR Scenarios Eleni Bassiakou, Konstantinos Stroumpoulis, and Theodoros Xanthos Department of Anatomy, School of Medicine, University of Athens, 11527 Athens, Greece Correspondence should be addressed to Eleni Bassiakou, nbassiakou@yahoo.com Received 31 May 2012; Accepted 11 July 2012 Academic Editors: P. Eisenburger and O. Karcioglu Copyright © 2012 Eleni Bassiakou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives. In this study, we investigated whether minimally trained paramedics with no previous experience in securing the airway would be more efficient in placing laryngeal mask airway (LMA) than intubating the trachea with direct laryngoscopy using 2 manikin scenarios: without chest compressions (non-CPR scenario) and with continuous chest compressions (CPR scenario). Methods. One hundred and twenty-four paramedics with no previous experience in managing the airway comprised our study population. Three 20 min lectures on the anatomy of the airway and endotracheal intubation with the Macintosh blade and LMA placement were given. Each participant attempted to insert a LMA or to intubate a manikin with the Macintosh blade using 2 different scenarios: without chest compressions and with continuous chest compressions. Results. All participants managed to place a LMA in both scenarios, but only 85% of them managed to intubate the trachea using the Macintosh blade in the non-CPR and even less than (80%) in the CPR scenario. Insertion of the LMA was statistically significantly faster than intubation with the Macintosh blade in both scenarios (P< 0.001). Conclusions. Our results provide evidence that for minimally trained paramedics, LMA insertion is much faster than endotracheal intubation. 1. Introduction Management of the airway is of utmost importance in the cardiopulmonary resuscitation (CPR) setting. Differ- ent devices and techniques, such as the endotracheal intubation and the laryngeal mask airway (LMA), have been recommended. Although standard direct laryngoscopic tracheal intubation remains the preferred technique to establish advanced airway management, sufficient experience is required to gain proficiency, and constant retraining is required in order to maintain the skill [1]. The classic laryngeal mask airway (LMA) on the other hand is easy to insert and when compared to endotracheal intubation is easier to learn [2, 3]. In the prehospital setting, airway management is often performed by paramedics under suboptimal conditions. Paramedic intubation has been a widely practiced aspect of prehospital cardiac arrest care for the past 20 years [4, 5]. However, survival after prehospital cardiac arrest may be improved by reducing paramedic intubation time [6]. This intrigued us to investigate whether minimally trained paramedics with no previous experience in securing the air- way would be more efficient in placing LMA or in intubating the trachea with direct laryngoscopy in a manikin study. Due to the fact that the latest European Resuscitation Council (ERC) Guidelines emphasize minimizing interruptions to chest compressions, in order to maximize coronary and cerebral perfusion pressure, the study was designed using 2 manikin scenarios: non-CPR and CPR with uninterrupted chest compressions [7, 8]. The primary endpoints in this study were success rate and time for LMA insertion or endotracheal intubation in these 2 scenarios. 2. Materials and Methods Paramedic personnel graduating in June 2010 were con- tacted. In total, 213 paramedics were identified and out of these, 152 consented to participate in the present study. After excluding those with previous experience in managing the