Essex Police Advanced Medics Training

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Laryngeal Mask Airway (LMA) Training
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Objectives

• Describe the LMA
• Outline the indications for use
• Outline the advantages
• Outline the disadvantages
• Select the correct size
• Prepare the device correctly
• Demonstrate safe insertion of the LMA
• Demonstrate how to secure correctly

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Assessment
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Describe the LMA
A single lumen tube with an eliptical cuff at
one end designed to sit over the Tracheal
entrance. The tip of the cuff lies in the
entrance to the oesophagus. When the cuff is
inflated it provides a degree of seal around
the trachea
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Parts
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Indications for use

• As an alternative to an oral airway
• As an immediate ventilation device capable of
  providing better protection of the
• upper airway than simple methods or OP airway
• It IS NOT a replacement for intubation
• It can be used as
• A device in failed intubation
• A device to aid intubation with a gum elastic
  boogie

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Advantages

• Simple piece of equipment
• Easy to insert blindly
• Well tolerated
• Diverts air into the trachea rather than
  oesophagus so is a better option than
• bag and mask etc (where the air goes into both)
• Lessens the risk of regurgitation
• Can be used to aid intubation
• Is a good bail out piece of kit (versus
  combitube)

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Disadvantages

• It does not protect the airway
• Can become dislodged especially when moving
  the patient
• The tube can be bitten through
• It can leak from around the cuff
• High airway pressures lessen the effectiveness
  of the device

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Sizing

• Portex disposable LMA
• Size 4 is issued to medics age 18 upwards

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Preparation of the device

• If time equalise pressure in cuff with outside
• Some models require deflation before use
• If time use lubricant gel on posterior side of
  cuff

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Correct insertion
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Insertion technique
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Insertion Technique

• Hold device like a pen
• Push the LMA against the roof of the mouth
• Follow the natural curve as far as your finger
  will go
• Hold the top of the LMA tube with your other
  hand
• Then remove your finger !
• Inflate the cuff (30 mls Air)
• The tube may move slightly as it positions
  itself
• Begin ventilation assess the chest etc
• Secure in place (OPA or gauze block and tape)

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Any questions ? 5 supervised insertions on
mannikin
Essex Police Advanced Medics Training