Laryngeal Mask Airway Insertion

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  • Primary rescue adjunct in the difficult airway
  • Potential backup device for difficult pediatric airways
  • Rescue device in cases of failed bag-mask ventilation
  • Difficult intubation
  • The LMA is relatively contraindicated in awake patients, especially those with a full stomach.
  • Decreased mouth opening may make insertion of the LMA difficult or impossible.
  • Insertion of the LMA may also be difficult or impossible in patients with severely distorted upper airway anatomy, especially those with scarring secondary to cervical radiation therapy.
  • LMA device
    • For emergency airway management the original LMA and the intubating LMA are the most practical.
    • The LMA Classic™ can be used up to 40 times before being replaced.
    • The LMA Unique™ is a single-use version of the LMA Classic.
    • The LMA Classic™ and LMA Unique™ are available in all sizes up to 5, including pediatric and neonatal sizes. The Classic also is available in size 6.
  • Oral cavity and oropharynx
    • The oral cavity extends superiorly to meet the posterior nasopharynx and blends inferiorly with the laryngeal inlet and superior esophageal space.
  • Larynx
    • Anterior structures include the hyoid bone, epiglottis, thyrohyoid membrane, and the thyroid cartilage.
    • Inferior and behind the larynx are the left and right piriform recesses, which in the midline are contiguous with the upper esophagus.
  • Trachea
    • The trachea begins after the cricoid cartilage.
    • The average tracheal diameter is 10-12 mm and on average can accommodate an 8.0 endotracheal tube.

Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

  • Confirm adequate airway placement by checking for bilateral breath sounds and chest movement with ventilation. A CO2 detector may also be helpful in confirming adequate placement.
  • After successful placement of the LMA, placement of an endotracheal tube may be indicated in patients who require ongoing airway management.
  • Aspiration of gastric contents
  • Failure to adequately ventilate and oxygenate
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