Dr AbdollahiDr Abdollahi

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LMALMA

The laryngeal mask airway (LMA) is an The laryngeal mask airway (LMA) is an ingenious supraglottic airway device that ingenious supraglottic airway device that is designed to provide and maintain a seal is designed to provide and maintain a seal around the laryngeal inlet for spontaneous around the laryngeal inlet for spontaneous ventilation and allow controlled ventilation ventilation and allow controlled ventilation at modest levels at modest levels (<15 cm H20)(<15 cm H20) of positive of positive pressure. pressure.

• This device is available in seven sizes This device is available in seven sizes for neonates, infants, young children, for neonates, infants, young children, older children, and small, normal, older children, and small, normal, and large adults.and large adults.

LMA generallyLMA generally unsuitable unsuitable for use in the conscious for use in the conscious emergency room patient. emergency room patient.

The The index fingerindex finger of the dominant hand is used to of the dominant hand is used to guide the LMA into the hypopharynx until guide the LMA into the hypopharynx until resistance is felt, and the cuff then is inflated with resistance is felt, and the cuff then is inflated with the appropriate volume of air.the appropriate volume of air.

It is important to check by capnography,It is important to check by capnography,

auscultation, and visualization of air auscultation, and visualization of air movement that the cuff is correctly movement that the cuff is correctly positioned and has not produced positioned and has not produced obstruction from downward displacement obstruction from downward displacement of the epiglottis.of the epiglottis.

The laryngeal mask airway is available in seven The laryngeal mask airway is available in seven sizes :sizes :

1.1.size 1, neonates or infants up to 5 kg (4 mL);size 1, neonates or infants up to 5 kg (4 mL);2.2.size 1.5, infants 5 to 10 kg (7 mL);size 1.5, infants 5 to 10 kg (7 mL);3.3. size 2, infants or children 10 to 20 kg (10 size 2, infants or children 10 to 20 kg (10

mL);mL);4.4. size 2.5, children 20 to 30 kg (14 mL); size 2.5, children 20 to 30 kg (14 mL); 5.5.size 3, children or small adults weighing size 3, children or small adults weighing

more than 30 kg (20 mL);more than 30 kg (20 mL);6.6. size 4, normal and large adults (30 mL); size 4, normal and large adults (30 mL); 7.7.size 5, large adults (40 mL).size 5, large adults (40 mL).

Colour coding change to account for colour blindness

The The Combitube Combitube is another supraglottic is another supraglottic airway device that can provide an airway device that can provide an emergency airway when conventional emergency airway when conventional means are not effective or possible. means are not effective or possible.

The The CombitubeCombitube has been used successfully has been used successfully in cardiopulmonary resuscitation and in cardiopulmonary resuscitation and probably presents a lower risk of probably presents a lower risk of esophageal ruptureesophageal rupture

than the older esophageal obturator airway.than the older esophageal obturator airway.

Combitube is Combitube is contraindicatedcontraindicated for for patients less than 5 feet tall and patients less than 5 feet tall and those with intact gag, esophageal those with intact gag, esophageal disease, or caustic ingestion. disease, or caustic ingestion.