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.

Airway Management with the Laryngeal Mask Airway (LMA) in Emergency Medical Services

2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S8-S11
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Oxygen Saturation ◽  
Emergency Medical Services ◽  
Success Rate ◽  
Laryngeal Mask ◽  
High Success Rate ◽  
Medical Services ◽  
Supraglottic Airway ◽  
Emergency Medical

Background: Airway management is an important aspect of care in emergency medical services (EMS) used to prevent obstruction of the respiratory track and inadequate oxygenation. The laryngeal mask airway (LMA) is an easy-to-use supraglottic airway device developed in 1988 that has a high success rate in both adults and children. However, there have yet been no studies regarding LMA use in EMS in Thailand. Objective: To determine the success rate of LMA in EMS and factors associated with successful LMA insertion. Materials and Methods: This was a cross-sectional study consisting of Srinagarind Hospital EMS patients over 18 years of age who underwent LMA airway management between March 2016 and March 2020. Data were collected from the Srinagarind Hospital EMS operation database and hospital information database system. Results: A total of 154 patients were enrolled with a mean age of 43.1+8.5 years, 89 (57.8%) of whom were male. Non trauma patients accounted for 72.7% of all cases. The average oxygen saturation before and after LMA use were 71.4+12.3% and 94.4+3.2%, respectively (p = 0.022). Students in their first and third year of residency training were able to successfully perform LMA airway management on the first attempt in 83.3% and 98.4% of cases, respectively (p = 0.025). Conclusion: Airway management using the LMA had a high success rate on the first attempt, required less time for insertion than other comparable devices, and resulted in a high level of oxygen saturation. Keywords: Laryngeal mask airway, Emergency medical services, Airway management, Internship and residency

scholarly journals Comparison of Airway Management during Anaesthesia Using the Laryngeal Mask Airway CTrach™ and Glidescope™

2007 ◽  
Vol 35 (5) ◽  
pp. 736-742 ◽  
Author(s):  
S. Y. Ng ◽  
F. Ithnin ◽  
Y. Llm
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Clinical Performance ◽  
Randomised Trial ◽  
Laryngeal Mask ◽  
Apparent Difference ◽  
Success Rates ◽  
Prospective Randomised Trial ◽  
Management Protocol ◽  
The Difference

The design of the Laryngeal Mask Airway CTrach™ combines the fibreoptic viewing capability of the Glidescope™ and the ability for ventilation of the Fastrach™. We conducted a prospective randomised trial comparing the intubation characteristics of the CTrach™ and Glidescope™ to investigate the difference in clinical performance for airway management during anaesthesia. One-hundred-and-six patients with normal airways were recruited and randomly assigned to the CTrach™ or Glidescope™ group. A standardised anaesthesia and airway management protocol was used. The time to intubation was significantly shorter for the Glidescope™ compared to the CTrach™ (43±22 vs. 73±36 s, P <0.001). The success rates of intubation within first and three attempts were significantly higher for Glidescope™. There was no apparent difference in complications of device insertion. Our results suggest that during elective management of normal airways, the time to intubation with the Glidescope™ is significantly shorter than the CTrach™. Further studies are required to compare these devices in patients with difficult airways.

Training for neonatal resuscitation with the laryngeal mask airway: a comparison of the LMA-ProSeal and the LMA-Classic in an airway management manikin

2006 ◽  
Vol 16 (10) ◽  
pp. 1028-1031 ◽  
Author(s):  
MASSIMO MICAGLIO ◽  
NICOLETTA DOGLIONI ◽  
MATTEO PAROTTO ◽  
VINCENZO ZANARDO ◽  
CARLO ORI ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Neonatal Resuscitation ◽  
Laryngeal Mask

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.

Supreme Laryngeal Mask Airway versus Face Mask during Neonatal Resuscitation: A Randomized Controlled Trial

2015 ◽  
Vol 167 (2) ◽  
pp. 286-291.e1 ◽  
Author(s):  
Daniele Trevisanuto ◽  
Francesco Cavallin ◽  
Loi Ngoc Nguyen ◽  
Tien Viet Nguyen ◽  
Linh Dieu Tran ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Laryngeal Mask Airway ◽  
Controlled Trial ◽  
Neonatal Resuscitation ◽  
Face Mask ◽  
Laryngeal Mask ◽  
Randomized Controlled

To compare the frequency of postoperative sore throat with I-gel versus laryngeal mask airway in patients

2021 ◽  
Vol 15 (12) ◽  
pp. 3232-3235
Author(s):  
M. J. Ahmed Kamal ◽  
Baber Zaheer ◽  
Naveed Ahmed Durrani ◽  
Khaleel Ahmad ◽  
Sumara Tabassam ◽  
...  
Keyword(s):  
Laryngeal Mask Airway ◽  
General Anesthesia ◽  
Sore Throat ◽  
Laryngeal Mask ◽  
Supraglottic Airway ◽  
Postoperative Sore Throat ◽  
Significant Difference ◽  
Group A ◽  
Group Members ◽  
Group B

Background: In case of general anesthesia, airway maintenance along with least complications is the most important goal of team of anesthesiologists. In case of clinical practice, the laryngeal mask airway (LMA) devices have superiority in managing supraglottic airway. Recently i-gel airway has been introduced as supraglottic airway equipment (disposable). Aim: To make comparison between laryngeal mask and I-gel with respect to postoperative complication of sore throat in case of patients who were given general anesthesia. Study design: Randomized trial Setting: Anesthesia Department Study duration: 6 after synopsis approval in total 6months of duration Methods: Candidates were divided randomly divided into two groups. In case of members of group A, patients were given i-gel where as members of group B, disposable LMA was given. General anesthesia was administered according to the standardized protocols. A day after operation, candidates were check post operatively for 24 hours, for sore throat and information was documented on Performa. Results: The candidates mean age was 44.23±15.11years in case of i-gel group members whereas 46.10±15.56 years in case of LMA group. In case of i-gel group, there were about twenty five males members and thirty five were females members . In case of LMA group members, there were about twenty six males and thirty four female members . In present case research, sore throat postoperatively was seen in case of 17(14.2%) cases, i.e. 4 (6.7%) in i-gel group while 13(21.7%) in case of LMA group. The significant difference was witnessed between members of both groups (p<0.05). Conclusion: Thus i-gel is better than LMA for general anesthesia as it has fewer chances of side effects like postoperative sore throat. Keywords: Postoperative sore throat, I-gel, laryngeal mask airway, general anesthesia

The Use of a Laryngeal Mask Airway for Emergent Airway Management in a Prone Child

2005 ◽  
Vol 100 (3) ◽  
pp. 670-671 ◽  
Author(s):  
R Scott Dingeman ◽  
Liliana C. Goumnerova ◽  
Susan M. Goobie
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Laryngeal Mask ◽  
Emergent Airway Management
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