Airway Skills 7:
King Airway
The King Airway System™ (King LTS-D, King LT-D, King LT) is a supraglottic airway that is inserted blindly. The King airway consists of a curved tube with ventilation apertures located between 2 inflatable cuffs. A single valve/pilot balloon is used to inflate both cuffs. The distal cuff seals the esophagus; the proximal cuff seals the oral pharynx. Both cuffs are high-volume, low-pressure cuffs. A 15-mm adaptor attaches to the proximal end of the tube for attachment to a standard breathing circuit or resuscitation bag.
The King airway is intended for airway management in patients over 4 feet tall for controlled or spontaneous ventilations. The King airway is contraindicated for patients who have a gag reflex, known esophageal disease (eg, cancer, varices, stricture), laryngectomy with a stoma, and/or caustic ingestion or airway burns.
King airway is available as a disposable tube or as a tube that can be sterilized. It requires a smaller mouth opening (23 mm), and its curved design decreases the chance of the tube going into the trachea.
Insertion
- Apply chin lift and introduce the King tube into the corner of the mouth.
- Advance tip under base of tongue, while rotating tube back to midline.
- Without exerting excessive force, advance tube until base of connector is aligned with teeth or gums.
- Inflate cuff according to package reference or volume noted on tube.
Size 3 – 50 mL
Size 4 – 70 mL
Size 5 – 80 mL
- Attach resuscitator bag. While gently bagging, slowly withdraw tube until ventilation is easy and free flowing (large tidal volume with minimal airway pressure).
Contraindications
The King LT-D does not protect the airway from regurgitation and aspiration effects. These contraindications are applicable for routine use of the King LT-D:
- Responsive patients with an intact gag reflex
- Patients with known esophageal disease
- Patients who have ingested caustic substances
For more detailed information, see the manufacturer’s instructions.