Abstract
Background
The LMA Fastrach (LMA North America, Inc; hereafter termed the intubating laryngeal mask airway [ILMA]) is an extraglottic device designed to facilitate endotracheal intubation.
After the endotracheal tube is placed through the lumen of the ILMA into the trachea,
the ILMA is removed, using a proprietary stabilizer rod to hold the tube in place.
Discussion
The traditional method of ILMA removal is not optimized for the critically ill patient.
It requires the use of unfamiliar equipment, exposes the patient to a significant
period without ventilation, and risks tube dislodgement. We designed a simple technique
with a double-endotracheal tube setup that addresses these problems using common equipment,
allowing for continuous ventilation, and minimizing the risk of tube dislodgement.
Conclusions
The traditional method of ILMA removal around an endotracheal tube is not designed
for critically ill patients or the physicians taking care of them. This novel technique
is designed to improve the usability of the ILMA for physicians and improve airway
outcomes for patients.
Keywords
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REFERENCES
- Use of the intubating laryngeal mask airway in emergency pre-hospital difficult intubation.Resuscitation. 2008; 77: 30-34
- Use of the intubating laryngeal mask airway.Anesthesiology. 2000; 93: 340-345
- Use of the intubating laryngeal mask airway in the emergency department: a ten-year retrospective review.Am J Emerg Med. 2020; 38: 1367-1372
- The intubating laryngeal mask. I: development of a new device for intubation of the trachea.Br J Anaesth. 1997; 79: 699-703
- LMA-Fastrach™ Instruction Manual.LMA North America;. 1998;
- The intubating LMA: a comparison of insertion techniques with conventional tracheal tubes.Can J Anaesth. 2000; 47: 849-853
- The intubating laryngeal mask. Results of a multicentre trial with experience of 500 cases.Anaesthesia. 1998; 53: 1174-1179
- Use of the Intubating LMA-FastrachTM in 254 patients with difficult-to-manage airways.Anesthesiology. 2001; 95: 1175-1181
- Unanticipated difficult airway management in the prehospital emergency setting: prospective validation of an algorithm.Anesthesiology. 2011; 114: 105-110
- Small endotracheal tubes. ventilator and intratracheal pressures during controlled ventilation.Surv Anesthesiol. 1979; 51: 375-381
Article info
Publication history
Published online: April 30, 2022
Accepted:
April 23,
2022
Received in revised form:
January 3,
2022
Received:
August 12,
2021
Footnotes
Streaming video: One brief real-time video clip that accompanies this article is available in streaming video at www.journals.elsevierhealth.com/periodicals/jem. Click on Video Clip 1.
Identification
Copyright
© 2022 Published by Elsevier Inc.
