 Description:
The
Intubating LMA has a rigid silicone-coated, anatomically curved
steel airway tube, which closely follows the curvature of the
palate and posterior pharynx. The distal end features an epiglottis-elevating
bar to lift the epiglottis and allow passage of a tracheal tube
or fiberoptic laryngoscope.
Indications:
- Guide
for endotracheal intubation
- Unanticipated
difficult intubations
- Failed
intubation
- Intubation
of patients with limited head/neck movement
Contraindications:
- Lack
of skill
- Non-fasted
patient
Advantages:
- Portable,
relatively inexpensive
- Large
internal diameter to accommodate up to a size 8.0 ETT
- Allows
ventilation/oxygenation throughout intubation attempts
- Rigid
handle eliminates need to place fingers in the mouth and allows
for manipulation of the device
Disadvantages:
- Blind
technique, potential trauma if not performed carefully
- Requires
mouth opening of at least 3cm
Special
Features:
- Allows
intubation/ventilation in any patient position
- May
be re-inserted after intubation to facilitate extubation
Tips for Success:
- Achieve
optimal ventilation (without leak) prior to intubation attempts
- Manipulate
the handle and lift prior to intubation ("Chandy's maneuver")
- Utilize
fiberoptic scope to visualize passage in very abnormal airways
- Use
proper size
Currently available devices:
For
additional information contact LMA
North America, Inc.
References:
-
Brain
AIJ, Verghese C, Addy EV, Kapila A. "The Intubating Laryngeal
Mask-I. Development of a New Device for Intubating the Trachea."
Brit J Anaesth 79:699, 1997.
-
Baskett
PJF, Parr MJA, Nolan JP.. "The Intubating Laryngeal Mask.
Results of a Multicentre Trial with Experience of 500 Cases."
Anaesthesia 53:1174, 1998.
-
Dhar
P, Osborn I, Brimacombe J, et al. "Blind Orotracheal Intubation
with the Intubating Laryngeal Mask vs. Fiberoptic Guided Orotracheal
Intubation with the Ovassapian Airway. A Pilot Study of Awake
Patients." Anesth Intensive Care 29:252, 2001.
|
