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The laryngoscope and the laryngeal mask airmay

In all the correspondence on insertion of the laryngeal mask airway (LMA) I am surprised to have seen no reference to the use of the Macintosh laryngoscope. This little gadget, present in every anaesthetic room and resuscitation area, makes LMA insertion easy and atraumatic. The laryngoscope lifts the base of the tongue and epiglottis away from the posterior pharyngeal wall, and creates a space into which the LMA can be seen to pass unobstructed. Although the use of a laryngoscope detracts from the simplicity of the LMA, I suggest that it be considered in the early stages of teaching, and also in otherwise difficult insertions and failed tracheal intubations.