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Ambu® AuraGain™ laryngeal mask as a method of airway management of patient entrapped in vehicle

      We read the article by Evrin et al. [
      • Evrin T.
      • Iskrzycki L.
      • Gawlowski P.
      The usage of Ambu® AuraGain™ laryngeal mask airway by the lifeguards.
      ] investigating the use of Ambu® AuraGain™ laryngeal mask by firefighters with a great interest. Undoubtedly, it is vitally important to keep looking for new methods of maintaining airway patency and to educate both medical and emergency services personnel in this aspect of medicine [
      • Sip M.
      • Dabrowska A.
      • Prucnal K.
      • Puslecki M.
      • Klosiewicz T.
      Supraglottic devices — future or everyday life?.
      ]. One group, from the emergency services personnel, which was examined by Evrin et al. [
      • Evrin T.
      • Iskrzycki L.
      • Gawlowski P.
      The usage of Ambu® AuraGain™ laryngeal mask airway by the lifeguards.
      ] are lifeguards, however, firefighters are another professional group that operates within emergency situations. Oftentimes firefighters or policemen arrive at the scene before the emergency medical team does. Additionally, where there is a possibility of danger at the scene of the event the only group that is able to operate in these conditions is firefighters-paramedics since they are equipped with specialized equipment, including the airway protection gear. In a situation where the patient is stuck in a vehicle and the access to the patient is limited, therefore intubation of the tracheal tube is difficult or even impossible to perform [
      • Szarpak Ł.
      • Truszewski Z.
      • Smereka J.
      • Evrin T.
      • Czyzewski Ł.
      Are paramedics able to perform endotracheal intubation with access to the patient through the back seat of the car? Randomized crossover manikin study.
      ,
      • Szarpak L.
      • Truszewski Z.
      • Czyzewski L.
      • Gaszynski T.
      • Rodríguez-Núñez A.
      A comparison of the McGrath-MAC and Macintosh laryngoscopes for child tracheal intubation during resuscitation by paramedics. A randomized, crossover, manikin study.
      ,
      • Smereka J.
      • Ladny J.R.
      • Naylor A.
      • Ruetzler K.
      • Szarpak L.
      C-MAC compared with direct laryngoscopy for intubation in patients with cervical spine immobilization: a manikin trial.
      ], the supraglottic airway devices may be the only real alternative allowing for airway patency maintenance [
      • Ladny J.R.
      • Bielski K.
      • Szarpak L.
      • Cieciel M.
      • Konski R.
      • Smereka J.
      Are nurses able to perform blind intubation? Randomized comparison of I-gel and laryngeal mask airway.
      ,
      • Kurowski A.
      • Hryniewicki T.
      • Czyżewski L.
      • Karczewska K.
      • Evrin T.
      • Szarpak Ł.
      Simulation of blind tracheal intubation during pediatric cardiopulmonary resuscitation.
      ,
      • Bielski K.
      • Smereka J.
      • Ladny J.R.
      • Szarpak L.
      A comparison of the Macintosh laryngoscope and blind intubation via I-gel in intubating an entrapped patient: a randomized crossover manikin study.
      ]. It should be underlined that in trauma patients the main cause of cardiac arrest are airway obstruction and progressive hypoxia. We currently are able to use the third generation of many supraglottic devices. One of these devices is Ambu® AuraGain™ laryngeal mask, which is 3rd generation laryngeal mask, satisfying 3 fundamental airway management needs by integrating gastric access and intubation capability in an anatomically curved single-use device.
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      References

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