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Insertion of a laryngeal mask airway

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VOL: 98, ISSUE: 01, PAGE NO: 45

PHIL JEV0N, RESUSCITATION OFFICER, ANDREW TAMMS, SENIOR NURSE THEATRES, MANOR HOSPITAL, WALSALL; JAGTAR SINGH POONI, CONSULTANT IN ANAESTHESIA AND INTENSIVE CARE, CITY HOSPITAL, BIRMINGHAM

Tracheal intubation is the gold standard for securing the airway during cardiopulmonary resuscitation. As extensive training and regular practice are required to attain and maintain this skill, it is often undertaken only by an experienced practitioner (usually an anaesthetist). However, a laryngeal mask airway (LMA) can be used to establish a clear airway while waiting for a patient to be intubated.

Tracheal intubation is the gold standard for securing the airway during cardiopulmonary resuscitation. As extensive training and regular practice are required to attain and maintain this skill, it is often undertaken only by an experienced practitioner (usually an anaesthetist). However, a laryngeal mask airway (LMA) can be used to establish a clear airway while waiting for a patient to be intubated.

An LMA is a curved, wide-bore tube with a spoon-shaped inflatable cuff. When the cuff is inflated, it seals the hypopharynx around the laryngeal opening. It can be used up to 40 times after sterilisation.

The LMA has been successfully used by nurses during cardiopulmonary resuscitation (Baskett, 1994).

Ventilation using a bag/valve/LMA device is more efficient, and certainly easier, than the conventional bag/valve/mask device, and the incidence of regurgitation is lower (Resuscitation Council (UK), 2000). Its use is also indicated in the 'cannot ventilate, cannot intubate' situation (Resuscitation Council (UK), 2000).

Unlike a cuffed tracheal tube, the LMA does not protect the airway from aspiration of gastric contents. However the incidence of aspiration is reported to be low (Owens et al., 1995).

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