BIAD LMA

 

Clinical Indications:

 

  • 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!

 

Clinical  Contraindications:

 

  • Deforming facial trauma.
  • Pulmonary fibrosis.
  • Morbid obesity.

 

Procedure:

 

  1. Check the tube for proper inflation and deflation.
  2. Lubricate with a water-soluble jelly.
  3. Pre-oxygenate the patient with 100% Oxygen.
  4. Insert the LMA into the hypopharynx until resistance is met.
  5. Inflate the cuff until a seal is obtained.
  6. Connect the LMA to an ambu bag and assess for breath sounds and air entry.
  7. Confirm tube placement using end-tidal CO2 detector or esophageal bulb device.
  8. Secure the tube to the patient’s face.
  9. Monitor oxygen saturation with pulse oximetry and heart rhythm with EKG.
  10. It is required that the airway be monitored continuously through waveform capnography and pulse oximetry.
  11. Re-verify LMA placement after every move and upon arrival in the emergency department.
  12. Document the procedure, time, and result (success) on/with the patient care report (PCR).
  13. Complete an airway form