Outline the role of the Laryngeal Mask Airway in the critically ill patient.
The Laryngeal Mask Airway has a number of potential roles in the ICU:
• Most important role is as part of the difficult airway algorithm (use to ventilate when cannot intubate; easily taught, good success rate, buys time)
• Can be used as a conduit for bronchoscopy and/or intubation in a patient who is difficult to intubate
• Could be considered as part of cardiac arrest management as an alternative in establishing airway and ventilation by practitioners not expert in the use of the endotracheal tube
• Can be used to maintain airway and ventilation during the performance of a percutaneous tracheotomy
• As an alternative airway during procedures in the ICU
Other variations have been developed (including the intubating laryngeal mask, which is one of the techniques that could be used for the patient who is difficult to intubate).
The above list is almost complete.
In summary, the ICU uses of the LMA are:
- As a backup for "can't intubate, cant ventilate" scenarios
- You can intubate though it
- You can pass a bronchoscope through it for tracheostomy
- You can temporarily ventilate somebody during a procedure
- You can use it during an arrest instead of an ETT, if skilled staff are not available