Airway management by physicians wearing anti-chemical warfare gear: comparison between laryngeal mask airway and endotracheal intubation

2002 ◽  
Vol 19 (3) ◽  
pp. 166-169 ◽  
Author(s):  
Zeev Goldik ◽  
Jacob Bornstein ◽  
Arieh Eden ◽  
Ron Ben-Abraham
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Endotracheal Intubation ◽  
Chemical Warfare ◽  
Laryngeal Mask

scholarly journals Unilateral Vocal Cord Paralysis following Insertion of a Supreme Laryngeal Mask in a Patient withSjögren’sSyndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
T. O. J. Masarwa ◽  
I. H. F. Herold ◽  
M. Tabor ◽  
R. A. Bouwman
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Vocal Cord ◽  
Endotracheal Intubation ◽  
Vocal Cord Paralysis ◽  
Case Reports ◽  
Ease Of Use ◽  
Laryngeal Mask ◽  
Less Invasive ◽  
Unilateral Vocal Cord Paralysis

Since its introduction in 1988 by Dr. Archie Brain, the laryngeal mask airway (LMA) is being used with increasing frequency. Its ease of use has made it a very popular device in airway management and compared to endotracheal intubation it is less invasive. The use of LMA was on the rise, so has been the incidence of its related complications. We report severe unilateral vocal cord paralysis following the use of the supreme laryngeal mask (sLMA) in a patient withSjögren’ssyndrome. In addition, we propose possible mechanisms of injury, review the existing case reports, and discuss our findings.

AN OBSERVATIONAL STUDY TO EVALUATE THE HAEMODYNAMIC CHANGES BETWEEN ENDOTRACHEAL INTUBATION AND LARYNGEAL MASK AIRWAY INSERTION

2021 ◽  
pp. 56-58
Author(s):  
Rahul Kumar ◽  
Anant Prakash ◽  
Chandeshwar Choudhary ◽  
Debarshi Jana
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Laryngeal Mask Airway ◽  
Observational Study ◽  
Arterial Pressure ◽  
Airway Management ◽  
Endotracheal Intubation ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion

Introduction: Airway management is a crucial skill for the clinical anaesthesiologist. It is an integral part of general anesthesia, allowing ventilation and oxygenation as well as a mode for anesthetic gas delivery. The laryngeal mask airways (LMA) have become popular in airway management as a missing link between facemask and tracheal tube in terms of both anatomical position and degree of invasiveness. Haemodynamic stability is an important aspect to the anaesthesiologist for the benet of the patients especially during intubations, laryngeal mask insertion. Laryngoscopy and endotracheal intubation can cause striking changes in Haemodynamics as result of intense stimulation of sympathetic nervous system. The aim of this study was to evaluate the hemodynamic changes between endotracheal intubation and laryngeal mask airway insertion. Material And Methods: This was a prospective observational study on 46 patients of ASA I-II status divided into 2 groups of 23 each. In the ETT (Endotracheal tube) group endotracheal intubation was done using Macintosh laryngoscope by using portex cuffed endotracheal while in LMA (Laryngeal mask airway) group laryngeal mask airway was inserted according to the standard recommendation. Heart rate, Systolic, Diastolic and Mean arterial pressure and dysrhythmias were monitored. Results: The two groups were comparable in terms of demographic data as there were no signicant differences between the 2 groups in terms of age, sex, duration of surgery, ASA grades and MPC classication. Heart rate (HR), Systolic blood pressure (SBP), Diastolic blood pressure(DBP), Mean arterial pressure (MAP) remains on higher side in ETT group than LMA group which was statistically signicant. P<0.05. Dysrhythmias were noted in 2 patients of ETT group while LMA group did not notice any dysrhythmias. Conclusion: This study demonstrated that there is a haemodynamic response consisting of an increase in Heart rate, SBP, DBP and MAP that comes with ETT insertion as well as with LMA insertion. However, the response caused by ETT insertion is signicantly greater than that caused by LMA insertion.

scholarly journals Comparison of Supreme laryngeal mask airway versus endotracheal intubation for airway management during general anesthesia for Cesarean section: a randomized controlled trial

2019 ◽  
Author(s):  
Wei Yu Yao ◽  
Shi Yang Li ◽  
Yong Jin Yuan ◽  
Hon Sen Tan ◽  
Nian-Lin Reena Han ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Cesarean Section ◽  
Airway Management ◽  
General Anesthesia ◽  
Endotracheal Intubation ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Elective Cesarean Section ◽  
Randomized Controlled ◽  
Reduced Time

Abstract Background The obstetric airway is a significant cause of maternal morbidity and mortality. Endotracheal intubation is considered the standard of care but the laryngeal mask airway (LMA) has gained acceptance as a rescue airway and has been incorporated into the obstetric airway management guidelines. In this randomized controlled equivalence trial, we compared the Supreme LMA (SLMA) with endotracheal intubation (ETT) in managing the obstetric airway during cesarean section. Methods Parturients who underwent elective cesarean section under general anesthesia were randomized to receive either an SLMA or ETT as their airway device. Our primary outcome was first-attempt insertion success. Successful insertion was defined as adequate bilateral air entry with auscultation and the presence of end-tidal carbon dioxide on the capnogram. The first-attempt insertion success rate was compared using the Chi-Square test. Secondary outcomes included time-to-ventilation, seal pressure, ventilation/hemodynamic parameters, occurrence of clinical aspiration, foetal outcomes, and maternal side effects associated with the airway device. Results We recruited 920 parturients (460 SLMA, 460 ETT) who underwent elective Caesarean section under general anesthesia. Patient characteristics were similar between the groups. First attempt success was similar (Odds Ratio--ORSLMA/ETA: 1.00 (95%CI: 0.25, 4.02), p = 1.0000). SLMA was associated with reduced time to effective ventilation (Mean Difference--MD -22.96; 95%CI: -23.71, -22.21 seconds) compared to ETT group (p<0.0001). Ventilation parameters, maternal and fetal outcomes were similar between the groups, and there was no aspiration. Conclusions SLMA could be an alternative airway management technique for a carefully selected low-risk obstetric population, with similar insertion success rates, reduced time to ventilation and less hemodynamic changes compared with ETT. Our findings are consistent with the airway guidelines in recommending the second line use of LMA in the management of obstetric airway.

scholarly journals Comparison of the Skill of Emergency Medical Technicians in Terms of Advanced Airway Management Using Endotracheal Tube vs Laryngeal Mask Airway in an OSCE Using a Mannequin

2020 ◽  
Author(s):  
Peyman Saberian ◽  
Ehsan Karimialavijeh ◽  
Mostafa Sadeghi ◽  
Mojgan Rahimi ◽  
Parisa Hasani-Sharamin ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Emergency Medical ◽  
Advanced Airway ◽  
Significant Difference ◽  
The Mean

Background: Supraglottic airway management tools such as the laryngeal mask airway (LMA) have recently emerged as the first choice in pre-hospital and hospital airway management guidelines as well as an alternative strategy after endotracheal tube (ETT) placement failure. However, the pros and cons of the LMA compared to endotracheal intubation are still debated. Given that no study has been conducted to date on the skills of emergency medical technician (EMT) in airway management using LMA compared to endotracheal intubation, we decided to do a study in this regard. Methods: In this objective structured clinical examination (OSCE), EMTs who had a degree of associate or bachelor were participated. The examiner asked the examinees the required information and entered it in the pre-prepared checklists. The participants took part in a two-stage exam. In the first stage, the airway management of the simulated trauma patient was performed by endotracheal intubation, and in the second stage, the same scenario was performed with LMA. At each stage, the examiner evaluated the examinee's performance in 4 fields of Preparation, Pre-oxygenation, Position and Placement, and Post-intubation management using a standard checklist. In addition, the duration of the procedure from the beginning to the time of fixing the ETT or LMA was recorded and compared. Results: Totally, 105 EMTs participated in this study, of whom, 102 were male (97.1%). The mean age of the subjects was 36.4± 7.3 years old. Of the total participants, 72 passed both practical exams successfully, and they generally insert the LMA faster; so that the duration of intubation and LMA insertion in 1.4% and 30.6% were <1 min, respectively (p< 0.001). However, no significant difference was observed in terms of the mean time (p= 0.427). Conclusion: In the present study, the skills of the technicians participating in the study in performing advanced airway procedures were moderate, and also, it was found that their skills in LMA insertion were less than endotracheal tube insertion.

scholarly journals Comparison of Supreme laryngeal mask airway versus endotracheal intubation for airway management during general anesthesia for Cesarean section: a randomized controlled trial

2019 ◽  
Author(s):  
Wei Yu Yao ◽  
Shi Yang Li ◽  
Yong Jin Yuan ◽  
Hon Sen Tan ◽  
Nian-Lin Reena Han ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Laryngeal Mask Airway ◽  
Airway Management ◽  
General Anesthesia ◽  
Endotracheal Intubation ◽  
Controlled Trial ◽  
Elective Caesarean Section ◽  
Airway Device ◽  
Laryngeal Mask ◽  
Reduced Time

Abstract Background: The obstetric airway is a significant cause of maternal morbidity and mortality. Endotracheal intubation is considered the standard of care but the laryngeal mask airway (LMA) has gained acceptance as a rescue airway and has been incorporated into the obstetric airway management guidelines. In this randomized controlled trial, we compared the Supreme LMA (SLMA) with endotracheal intubation (ETT) in managing the obstetric airway during Caesarean section. Methods: Parturients who underwent elective Caesarean section under general anesthesia were randomized to receive either an SLMA or ETT as their airway device. Our primary outcome was first-attempt insertion success. Successful insertion was defined as adequate bilateral air entry with auscultation and the presence of end-tidal carbon dioxide on the capnogram. The first-attempt insertion success rate was compared using the Chi-Square test. Secondary outcomes included time-to-ventilation, seal pressure, ventilation/hemodynamic parameters, occurrence of clinical aspiration, fetal outcomes, and maternal side effects associated with the airway device. Results: We recruited 920 parturients (460 SLMA, 460 ETT) who underwent elective Caesarean section under general anesthesia. Patient characteristics were similar between the groups. First attempt success was similar (Risk Ratio--RRETT/SLMA: 1.00 (95%CI: 0.25, 4.02), p= 1.00). SLMA was associated with reduced time to effective ventilation (Mean Difference-- MD -22.96; 95%CI: -23.71, -22.21 seconds) compared to ETT group (p<0.0001). Ventilation parameters, maternal and fetal outcomes were similar between the groups, and there was no aspiration. Conclusions: SLMA could be an alternative airway management technique for a carefully selected low risk obstetric population, with similar insertion success rates, reduced time to ventilation and less hemodynamic changes compared with ETT. Our findings are consistent with the airway guidelines in recommending the second line use of LMA in the management of obstetric airway. Ethics Approval: This study was approved by the Institutional Review Board (approval obtained on 25th October 2012) at the Quanzhou Women’s and Children’s Hospital, Fujian Province, China (clinical trials registration number: NCT01858467). Keywords: Laryngeal Mask Airway, Obstetric, Cesarean Section, General Anesthesia.

Safe emergency neonatal airway management: current challenges and potential approaches

2021 ◽  
pp. fetalneonatal-2020-319398
Author(s):  
Joyce E O'Shea ◽  
Alexandra Scrivens ◽  
Gemma Edwards ◽  
Charles Christoph Roehr
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Neonatal Resuscitation ◽  
Laryngeal Mask ◽  
Viable Alternative ◽  
Supraglottic Airway ◽  
Success Rates ◽  
Facemask Ventilation

This review examines the airway adjuncts currently used to acutely manage the neonatal airway. It describes the challenges encountered with facemask ventilation and intubation. Evidence is presented on how to optimise intubation safety and success rates with the use of videolaryngoscopy and attention to the intubation environment. The supraglottic airway (laryngeal mask airway) is emerging as a promising neonatal airway adjunct. It can be used effectively with little training to provide a viable alternative to facemask ventilation and intubation in neonatal resuscitation and be used as an alternative conduit for the administration of surfactant.

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