Date of Award
Master of Science (MS)
Establishing and maintaining an airway is the first and most important step in the care of the critical patient. Although the endotracheal tube is the gold standard for establishing an airway, in many cases it is difficult to properly intubate the critical patient. There needs to be tool available to safely establish an airway that can be easily taught to non-anesthesia members of the healthcare team; that tool is the Laryngoscope Mask Airway (LMA).
By performing a literature review, the evidence shows that the LMA should be available on hospital crash carts for personnel to use in the event of a difficult intubation or staff not trained to intubate. The literature review identifies factors that necessitate the need for an alternative to intubation. The patient may have pre-existing factors and possess a difficult airway, or there could be factors from the emergency situation causing difficulty in proper intubation. Besides patient factors, there may not be trained anesthesia personnel available to respond to the emergency situation, leaving nurses, paramedics, and respiratory therapists as members of the healthcare team responsible for establishing an airway
The literature review investigated different methods available to help identify difficult airway scenarios in the patient as well as clinical factors that may lead to difficulties in establishing a patent airway. After determination of a difficult intubation, the positive and negative aspects of the LMA are investigated
The results of the data clearly show the advantages of the LMA far outweigh any disadvantages. The LMA is simple to use and healthcare providers can be easily trained to place the LMA. The LMA is safe with few side effects and provides a manageable airway for the critical patient. The LMA comes in different sizes and can serve a wide range of patient population. The data from this project also identified the many patient complications that can occur when an airway is not able to be placed, many of which can be life threatening
The literature and data support the conclusion that the LMA should be available on crash carts and that non-anesthesia personnel should be trained on the proper use in placing the LMA. With the factors defining problems with endotracheal intubation in the emergent situation clearly defined, there is a need for a safe alternative
Kelly, Karen J., "Laryngeal Mask Airway As An Adjunct To A Definitive Airway" (2009). Theses and Dissertations. 4750.