critical care medicine
How To Insert a Laryngeal Mask Airway
Introduction
Laryngeal mask airway (LMA) ventilation is a method for providing rescue ventilation to unconscious patients or patients without a gag reflex that is technically easier than use of most other effective ventilatory methods. It is used by anesthesiologists in many settings that previously required endotracheal intubation. (See also Airway Establishment and Control and The laryngeal mask airway (LMA) is a commonly used supraglottic airway. The LMA is an orally introduced supraglottic airway tube with a cuffed mask at one end that forms a low-pressure seal around the laryngeal inlet. LMA ventilation has several advantages over other methods. Unlike endotracheal tubes, LMAs can be successfully inserted blindly and by operators with only basic training. Unlike How To Do a Percutaneous Cricothyrotomy , LMAs avoid the difficulties of attaining and maintaining an adequate face-mask seal. They bypass soft tissue obstruction of the upper airway, and they cause less gastric insufflation than BVM ventilation. Some available types of LMAs allow passage of an endotracheal tube (intubating LMAs) or a gastric decompression tube. Some have a fixed, anatomically correct shape that further optimizes ease of insertion. Some newer mask designs replace the inflatable cuff with a gel–filled cuff that molds to the airway. LMAs, like the other supraglottic airways (eg, How To Insert an Esophageal-Tracheal Double Lumen Tube (Combitube) or a King Laryngeal Tube ), are temporary airways that must, after several hours, be removed or be replaced by a definitive airway, such as an endotracheal tube or surgical airway ( 