Tracheal intubation and cervical spine excursion: direct laryngoscopy vs. intubating laryngeal mask

Until recently, the most appropriate technique of intubating a patient with a cervical spine injury has been the subject of debate. Tracheal intubatio n by means of the intubating laryngeal mask (Fastrach (TM)), a modified con ventional laryngeal mask airway, seems to require less neck manipulation. T he aim of this study was to compare the excursion of the upper cervical spi ne during tracheal intubation using direct laryngoscopy with that during in tubation via the laryngeal mask (Fastrach (TM)), by examination of lateral cervical spine radiographs in healthy young patients. The intubating laryng eal mask (Fastrach (TM)) caused less extension (at C1-2 and C2-3) than intu bation by direct laryngoscopy. Direct laryngoscopy is still the fastest met hod to secure an airway provided no intubating difficulties are present. Ho wever, in trauma patients requiring rapid sequence induction and in whom ce rvical spine movement is limited or undesirable, the intubating laryngeal m ask (Fastrach (TM)) is a safe and fast method by which to secure the airway .