Theatre-Based Hospital Placements for Firefighters

Airway obstruction is the most common cause of death in the prehospital environment. It is estimated that 85% of these patients had otherwise survivable injuries. The aim of the project was to increase firefighters' skills in airway management techniques, to include the laryngeal mask airway (LMA), by providing theatre-based hospital placements under the supervision of a consultant anaesthetist. The training in the use of the LMA by firefighters is currently a pilot project to assess the potential for its use operationally, based on ease of training to a competent level and retention of skills after one year.

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Airway Management of the Severely Retrognathic Child: Use of the Laryngeal Mask Airway

Ear Nose & Throat Journal ◽

10.1177/014556130208100410 ◽

2002 ◽

Vol 81 (4) ◽

pp. 223-226 ◽

Cited By ~ 17

Author(s):

Rose Mary S. Stocks ◽

Robert Egerman ◽

Jerome W. Thompson ◽

Michael Peery

Keyword(s):

Laryngeal Mask Airway ◽

Airway Management ◽

Potential Problem ◽

Management Strategies ◽

Laryngeal Mask ◽

Intubation Technique ◽

Unique Challenge ◽

Pediatric Airway ◽

Life Saving ◽

Management Techniques

Successful airway management of an infant or child with moderate to severe retrognathia first requires recognition of a potential problem. If the child cannot be intubated in a standard fashion, the use of a laryngeal mask airway (LMA) should be considered. We describe two cases wherein a toddler and an infant with severe retrognathia failed multiple attempts at traditional intubation. Both had an anterior larynx and hypoplasia of the mandible. In both cases, a subsequent LMA was successfully placed. The severely retrognathic newborn or child presents to the physician a unique challenge in airway management. Techniques to manage this difficult pediatric airway are different from those used in the adult. Otolaryngologists should be aware of this intubation technique and include it in their armamentarium of airway-management strategies. The LMA is not recommended as the technique of choice for securing a difficult airway, but it is an effective alternative when indicated, and it might be life-saving.

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Safe emergency neonatal airway management: current challenges and potential approaches

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2020-319398 ◽

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

Anesthesia & Analgesia ◽

10.1213/01.ane.0000146512.48688.fa ◽

2005 ◽

Vol 100 (3) ◽

pp. 670-671 ◽

Cited By ~ 30

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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Laryngeal mask airway supremeTMfor difficult airway management and establishing ventilation in the intensive care unit

Indian Journal of Anaesthesia ◽

10.4103/0019-5049.126843 ◽

2014 ◽

Vol 58 (1) ◽

pp. 91 ◽

Cited By ~ 1

Author(s):

Mohd Saif Ghaus

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Laryngeal Mask Airway ◽

Airway Management ◽

Difficult Airway ◽

Laryngeal Mask ◽

Difficult Airway Management

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Success of placement and complications during v-gel placement and maintenance of anaesthesia

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x211050612 ◽

2021 ◽

pp. 1098612X2110506

Author(s):

Kathrin Hecker-Turkovic ◽

Katrin Hartmann ◽

René Dörfelt

Keyword(s):

Clinical Study ◽

Airway Management ◽

Airway Obstruction ◽

Endotracheal Intubation ◽

Laryngeal Mask ◽

Prospective Clinical Study ◽

Laryngeal Masks ◽

The Third ◽

Dorsal Position

Objectives Airway management during anaesthesia in cats is always a demanding task and is associated with several complications. The aim of this study was to evaluate the practicability and complications during feline-specific laryngeal mask placement in anaesthetised cats as an alternative to endotracheal intubation. Methods In this prospective clinical study, laryngeal masks were placed in 148 anaesthetised cats. Success of placement was evaluated by capnography. Results Placement was possible at the first attempt in 136 cats, at the second attempt in eight cats and at the third attempt in one cat. In one cat, placement was not possible. Two cats were excluded. Failure to position the laryngeal mask at the first attempt was not different between laryngeal mask sizes ( P = 0.313) or positioning during placement ( P = 0.406). In nine cats, the laryngeal mask dislocated during the procedure. Dislocation occurred more often in the dorsal position than in the sternal ( P = 0.018) and right lateral positions ( P = 0.046). Mucous obstruction of the laryngeal mask occurred in one of these cats and regurgitation in another. Material-related issues, such as disconnection of the parts of the laryngeal mask and leakage of the balloon, were observed in 2/8 laryngeal masks. Conclusions and relevance The placement of a feline-specific laryngeal mask was easy to perform. In about 7% of the cases, replacement of the device was required due to mispositioning or dislocation. Full monitoring, including capnography, should be provided to uncover dislocation and airway obstruction immediately.

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Emergency Airway Management with a Laryngeal Mask Airway in a Patient with Massive Cervical Lipomas

Anesthesiology ◽

10.1097/aln.0000000000002762 ◽

2019 ◽

Vol 131 (4) ◽

pp. 895-895

Author(s):

Omaira Azizad ◽

Carl Adkins ◽

Brandon Mitchell

Keyword(s):

Laryngeal Mask Airway ◽

Airway Management ◽

Laryngeal Mask ◽

Emergency Airway Management ◽

Emergency Airway

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Intubating Laryngeal Mask Airway

Anaesthesia and Intensive Care ◽

10.1177/0310057x0203000503 ◽

2002 ◽

Vol 30 (5) ◽

pp. 551-569 ◽

Cited By ~ 45

Author(s):

G. Caponas

Keyword(s):

Laryngeal Mask Airway ◽

Airway Management ◽

Difficult Airway ◽

Success Rate ◽

Laryngeal Mask ◽

Oesophageal Perforation ◽

Clinical Consequence ◽

Neutral Position ◽

Valuable Adjunct ◽

Intubating Laryngeal Mask Airway

The Intubating Laryngeal Mask Airway (ILMA) was introduced into clinical practice in 1997 following numerous clinical trials involving 1110 patients. The success rate of blind intubation via the device after two attempts is 88% in “routine” cases. Successful intubation in a variety of difficult airway scenarios, including awake intubation, has been described, with the overall success rate in the 377 patients reported being approximately 98%. The use of the ILMA by the novice operator has also been investigated with conflicting reports as to its suitability for emergency intubation in this setting.Blind versus visualized intubation techniques have also been investigated. These techniques may provide some benefits in improved safety and success rates, although the evidence is not definitive. The use of a visualizing technique is recommended, especially whilst experience with intubation via the ILMA is being gained. The risk of oesophageal intubation is reported as 5% and one death has been described secondary to the complications of oesophageal perforation during blind intubation. Morbidity described with the use of the ILMA includes sore throat, hoarse voice and epiglottic oedema. Haemodynamic changes associated with intubation via the ILMA are of minimal clinical consequence.The ILMA is a valuable adjunct to the airway management armamentarium, especially in cases of difficult airway management. Success with the device is more likely if the head of the patient is maintained in the neutral position, when the operator has practised at least 20 previous insertions and when the accompanying lubricated armoured tube is used.

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