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A I R W A Y
M A N A G E M E N T
adequacy of spontaneous ventilation;
• patients who are morbidly obese or have significant histories of
untreated gastroesophageal reflux disease;
• patients deemed to have full stomachs, because the device does
not offer any protection against aspiration of gastric contents.
Before use, visually inspect LMAs to ensure there are no obvious
defects, and that the ventilation channel is patent. Deflate the cuff fully,
and slowly re-inflate it to check for leaks. Selecting the correct LMA size
is usually weight-based, but sizing up or down may be necessary to
account for differences in individual patient oropharyngeal anatomy and
mouth opening. Proper placement technique includes extending the
head and neck and opening the mouth, followed by placing the device
into the oropharynx in a single smooth motion. Take care to prevent
folding the tip of the device onto itself and intrinsic obstruction from the
tongue.
One in every cart
Today's anesthesia providers can't imagine a world without LMAs.
They've become a critical tool in outpatient anesthetics, with established uses across all surgical disciplines. The many unique LMA configurations allow for the use of a device that is patient- and procedure-specific, for delivering optimal anesthetics and for achieving excellent surgical outcomes. OSM
Dr. De (dea@mail.amc.edu) is an assistant professor and division chief
of anesthesiology and Mr. Kattato (kattatd@ mail.amc.edu) is chief CRNA at
the South Clinical Campus at Albany Medical Center in Albany, N.Y.
O C T O B E R 2013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E
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