Name:
ACA- Hung 4e- Technique of Placement of Extraglottic Devices: Laryngeal Mask Airway Classic
Description:
ACA- Hung 4e- Technique of Placement of Extraglottic Devices: Laryngeal Mask Airway Classic
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/5661ea4e-e55b-4e96-9eb9-6756f3d770e0/videoscrubberimages/Scrubber_1.jpg?sv=2019-02-02&sr=c&sig=uEAEQCkjfYGF2RRe3OtRCgGBA1QLdC%2FHXVA%2Fg6zSyA8%3D&st=2025-05-11T09%3A37%3A15Z&se=2025-05-11T13%3A42%3A15Z&sp=r
Duration:
T00H03M00S
Embed URL:
https://stream.cadmore.media/player/5661ea4e-e55b-4e96-9eb9-6756f3d770e0
Content URL:
https://cadmoreoriginalmedia.blob.core.windows.net/5661ea4e-e55b-4e96-9eb9-6756f3d770e0/Technique of Placement of Extraglottic Devices- Laryngeal Ma.mov?sv=2019-02-02&sr=c&sig=MTUv%2FLnk0Z%2B678Ff1Gnm6e0svQcv5RRP9qLmo2VDQl8%3D&st=2025-05-11T09%3A37%3A15Z&se=2025-05-11T11%3A42%3A15Z&sp=r
Upload Date:
2023-11-24T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
[Dr. Hung] The Laryngeal Mask Airway Classic, or LMA Classic has a wide-bore airway tube connecting to an inflatable cuff that seals around the larynx. The distal airway tube has aperture bars to prevent obstruction by the epiglottis. Successful use of the LMA often depends on the selection of an appropriate size for the patient. Typically, a number 3 LMA is used in small adults, number 4, 5, and 6 in average in large-size adults.
Following complete deflation of the cuff, the LMA is well-lubricated with a water-soluble lubricant. Provided that there is no contraindication to moving the cervical spine, the patient's head and neck should be placed in a sniffing position. A head tilt will help to open the mouth. While many techniques have been suggested for the insertion of the LMA, the following steps are recommended.
Lift the mandible forward by grasping the mandibular incisors and chin with the non-inserting hand. The LMA should be inserted into the mouth with the index finger placed between the mask tube junction, pressing the cuff against the hard palate and advancing the LMA into the oropharynx, following the natural curve of the posterior pharyngeal wall.
A definite resistance should be felt as the tip of the LMA traverses the hypopharynx to its proper position. Following placement, the cuff should be inflated with the minimal volume of air necessary to achieve an adequate seal. The LMA should be secured in position by taping it to the face. Occasionally, the epiglottis folds downward during the LMA placement causing partial airway obstruction.
In order to have a clear access to the glottic opening and minimize downfolding of the epiglottis, it is recommended that the practitioner perform a jaw lift using the thumb and index finger of the non-dominant hand, as shown earlier. This lifts the tongue and epiglottis away from the posterior pharyngeal wall to facilitate placement of the LMA. Occasionally, resistance is encountered during insertion because of backward folding of the cuff.
Sweeping a finger behind the cuff to redirect it inferiorly into the laryngopharynx can easily overcome the problem, as shown in this video. A bite block should be placed to prevent biting and occlusion of the device, potentially leading to post-obstructive pulmonary edema.
