King Airway - LTS-D Supraglottic Airways

What is the difference between the King LT, King LT-D, and King LTS-D?

The King LT is the original inflatable laryngeal tube airway without gastric access. The King LT-D added a drain tube channel for gastric access (the 'D' designates Drain). The King LTS-D (Laryngeal Tube Suction-Disposable) is a disposable version of the LT-D with a straightened, beveled distal tip that better directs the device posterior to the larynx. The LTS-D's single-use disposable design eliminates reprocessing requirements and cross-contamination risk. The 'S' in LTS-D represents the Suction drain tube feature.

How is the King LTS-D inserted?

With the patient's head in a neutral or slightly extended position, apply lubricant to the device (included in kit). Open the patient's mouth, insert the device with the chin-lift or jaw-thrust technique, and advance the tube into the hypopharynx until the base of the connector is at the level of the teeth. Inflate both cuffs simultaneously using the single port with 60 mL. Confirm ventilation by auscultation and end-tidal CO2 if available. The device seals in the esophagus (distal cuff) and oropharynx (proximal cuff), with ventilation ports in between over the laryngeal inlet.

What size King LTS-D should I use for an average adult?

Size 4 is appropriate for patients with height 61–71 inches — which covers the majority of average adult Americans. Size 3 is for smaller adults under 61 inches (5'1"), and Size 5 is for large adults over 71 inches (5'11"). When patient height is unknown, estimate from body habitus: Size 4 is the best default for average adult males and females of typical build.

Can the King LTS-D be used for spontaneously breathing patients?

Yes. The King LTS-D is designed for use in both positive-pressure ventilation (non-breathing patients) and spontaneously breathing patients. The device maintains airway patency in both scenarios, with cuffs inflated to seal the oropharynx and esophagus. For spontaneously breathing but unconscious patients, the King LTS-D provides a secure airway conduit. However, as with all SGAs in the TCCC context, spontaneously breathing trauma patients who are conscious enough to breathe on their own may not tolerate SGA insertion without sedation.

How does the gastric drain tube work in the King LTS-D?

The King LTS-D has a separate lumen (drain tube channel) that runs alongside the ventilation lumen. After the device is seated and cuffs inflated, the 18Fr gastric tube from the kit can be passed through this drain channel into the stomach/esophagus for decompression of gastric contents. This reduces aspiration risk from regurgitation during positive-pressure ventilation and allows gastric medication administration if needed. The gastric diverter component helps direct the suction catheter properly through the channel.