Laryngeal Mask Airway喉罩

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1、LaryngealMaskAirwayHaiYuDepartmentofAnesthesiologyWestChinaHospitalSichuanUniversityIntroductionTheLMAwasinventedbyDr.ArchieBrainattheLondonHospital,Whitechapelin1981UK(1988),US(1991)TheLMAconsistsoftwoparts:ThemaskThetubeTheLMAhasproventobeveryeffectiveinthem

2、anagementofairwaycrisisIntroductioncontinuedTheLMAdesign:Providesan“ovalsealaroundthelaryngealinlet”oncetheLMAisinsertedandthecuffinflated.Onceinserted,itliesatthecrossroadsofthedigestiveandrespiratorytracts.IndicationsfortheuseoftheLMASituationsinvolvingadiff

3、icultmaskfit.Maybeusedasaback-updevicewhereendotrachealintubationisnotsuccessful.Maybeusedasa“second-last-ditch”airwaywhereasurgicalairwayistheonlyremainingoption.ContraindicationsoftheLMAGreaterthan14to16weekspregnantPatientswithmultipleormassiveinjuryMassiv

4、ethoracicinjuryMassivemaxillofacialtraumaPatientsatriskofaspirationNOTE:NotallcontraindicationsareabsoluteSide-EffectsoftheLMAThroatsorenessDrynessofthethroatand/ormucosaSideeffectsduetoimproperplacementvarybasedonthenatureoftheplacementEquipmentforLMAInsertio

5、nBodySubstanceIsolationequipmentAppropriatesizeLMASyringewithappropriatevolumeforLMAcuffinflationWatersolublelubricantVentilationequipmentStethoscopeTapeorotherdevice(s)tosecureLMAPreparationoftheLMAforInsertionStep1:SizeselectionStep2:ExaminationoftheLMAStep3

6、:CheckdeflationandinflationofthecuffStep4:LubricationoftheLMAStep5:PositiontheAirwayStep1:SizeSelectionVerifythatthesizeoftheLMAiscorrectforthepatientRecommendedSizeguidelines:Size1:under5kgSize1.5:5to10kgSize2:10to20kgSize2.5:20to30kgSize3:30kgtosmalladultSiz

7、e4:adultSize5:Largeadult/poorsealwithsize4Step2:ExaminationoftheLMAVisuallyinspecttheLMAcufffortearsorotherabnormalitiesInspectthetubetoensurethatitisfreeofblockageorlooseparticlesDeflatethecufftoensurethatitwillmaintainavacuumInflatethecufftoensurethatitdoes

8、notleakTEST:VISUALINSPECTIONStep3:DeflationandInflationoftheLMAStep1:LeakageDeflatethecuffsothatthecuffwallsaretightlyflattenedagainsteachother.DonotusetheLMA™airwayifthecuffwallsr