LMA

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

2. 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

3. 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