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Intro. to Airway Management -- LMA Lecture
First quarter airway management info. for AA students
32
Other
Graduate
08/31/2010

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Cards

Term
LMA
Definition
laryngeal mask airway
Term
What two materials are LMA's made of?
Definition
medical grade silicone (reusable)
PVC
Term
What is the main advantage of the LMA proseal?
Definition
it can be used at higher airway pressures (up to 30cmH2O)
Term
Does the LMA proseal have a built in bite block?
Definition
YES
Term
Features of the LMA supreme?
Definition
single use
built in bite block
drain tube
higher seal pressures than classic LMA
Term
Flexible LMA features
Definition
wire-reinforced
no resistance to occlusion from bite
Term
What is the official name of the intubating LMA?
Definition
LMA Fastrach
Term
Indications of LMA use
Definition
alternative to face mask
elective procedures where an ET tube isn't necessary
in a known/expected difficult airway
during resuscitation
Term
Contraindications to LMA use
Definition
-Not NPO patients
-Morbidly obese
->14 weeks gestation
-fixed pulmonary compliance
-massive injury
-abdominal/thoracic injury
-any condition w/delayed gastric emptying
Term
How to clean reusable LMA's
Definition
wash with warm water & soap
then autoclave (138 degrees C)
Term
Insertion preparation of the LMA
Definition
slightly inflate cuff so it's like a boat
lube posterior surface
Term
LMA insertion technique
Definition
slide along hard palate while applying pressure cranially with index finger
Term
What are the 3 LMA insertion techniques
Definition
index finger
thumb
proseal introducer
Term
Fixation & confirmation of LMA placement
Definition
insert bite block
tape LMA in place
confirm placement (LMA sits up when inflated, listen for bilateral chest sounds)
Term
Do you need to bag/mask ventilate before inserting LMA?
Definition
NO! The LMA is a mask!
Term
Is LMA removal more or less stimulating than with an ET tube?
Definition
Less stimulating
Term
Steps to LMA removal
Definition
don't suction below LMA
don't manipulate when patient is light
patient will begin to swallow
allow patient to awaken and follow commands
remove LMA & bite block
Term
What benefits does the reduced stimulation of an LMA provide?
Definition
no HR increase (good for people with CAD)
can use less drugs (people wake up easier & faster)
Term
What head/neck procedures can an LMA be used for?
Definition
Tonsillectomies
--shield larynx from blood
Airway tumor resections
--accommodates fiberoptic scope & doesn't disrupt laryngeal tumors
Term
Should you use the largest LMA possible?
Definition
Yes, to achieve the best seal
Term
Is muscle relaxation required for LMA use
Definition
No, it's a very gray area
no published data on frequency of muscle relaxant use with LMA's
Term
Is supine a good position for LMA use?
Definition
Yes, best choice
Term
Lateral position and LMA use
Definition
controversial
Term
Prone position and LMA use
Definition
has to be short case with perfect patient
Term
beach chair position and LMA use
Definition
LMA perfect for this
Term
incidence of aspiration while using an LMA
Definition
1-6 in 10,000
Term
LMA use for PPV
Definition
may be as effective as ETT
no leak until 20cmH2O
Term
What is the tidal vol. limit in LMA's
Definition
8mL/kg (lean body mass)
Term
LMA use in prolonged procedure
Definition
initially not recommended for >3 hours
used 4-8 hours with gastric suctioning
Term
Sore throat risk with LMA
Definition
less than with an ET tube
Term
What should the cuff pressure be in an LMA?
Definition
<60cmH2O
Term
LMA advantages
Definition
less invasive
less stimulating
less incidence of sore throat
useful for difficult airways
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