Lund Center for Emergency Medicine
Lund, Sweden
info@lucem.info

LMA

Clarity in Emergency Medicine

LARYNGEAL MASK AIRWAY

Indications

  • ”Cannot ventilate” sufficiently with bag-valve-mask +/- adjuncts

  • ”Cannot intubate:” LMA is an alternative to endotracheal intubation under direct visualization

  • ”Cannot intubate / cannot ventilate:” rescue measure prior to surgical airway

Contraindications

  • Awake or drowsy patient

  • Mouth opening < 2 cm

 

  1. Prior

  • Choose a laryngeal mask airway of the correct size

  • Choose a bag of the correct size

  • Deflate the cuff

  • Apply water-soluble lubricant on the posterior surface of the LMA

  1. Procedure

  • Open the patient’s mouth and move the mandible anteriorly

  • Insert the LMA along the hard palate (index-finger insertion technique)

  • Inflate the cuff

  • Attach the bag and ventilate

  1. Post

  • Assess chest movements

  • Assess for air leak around the LMA; adjust the placement of the LMA / air-volume in the cuff / patient’s head position as needed, or replace the LMA with one of a bigger size

  • Assess vital signs (e.g. SpO2%)

  • Fixate the LMA