- Longer EMS transport distances or an inability to adequately ventilate a patient with a bag valve mask requires a more advanced airway.
- Inability to secure an endotracheal tube in a patient who does not have a gag reflex where at least one failed intubation attempt has occurred.
- Appropriate intubation is impossible due to patient access or difficult airway anatomy.
WARNING: This airway does not prevent aspiration of stomach contents!
- Deforming facial trauma.
- Pulmonary fibrosis.
- Morbid obesity.
- Check the tube for proper inflation and deflation.
- Lubricate with a water-soluble jelly.
- Pre-oxygenate the patient with 100% Oxygen.
- Insert the LMA into the hypopharynx until resistance is met.
- Inflate the cuff until a seal is obtained.
- Connect the LMA to an ambu bag and assess for breath sounds and air entry.
- Confirm tube placement using end-tidal CO2 detector or esophageal bulb device.
- Secure the tube to the patient’s face.
- Monitor oxygen saturation with pulse oximetry and heart rhythm with EKG.
- It is required that the airway be monitored continuously through waveform capnography and pulse oximetry.
- Re-verify LMA placement after every move and upon arrival in the emergency department.
- Document the procedure, time, and result (success) on/with the patient care report (PCR).
- Complete an airway form