ALL THE CONTRAINDICATIONS TO USING A FIRST GENERATION LMA
Increased risk of aspiration: Prolonged bag-valve-mask ventilation, morbid obesity, second or third trimester pregnancy, patients who have not fasted before ventilation, upper gastrointestinal bleed
Need for high airway pressures; poor pulmonary compliance, high airway resistance
Suspected or known abnormalities in supraglottic anatomy
Place on a flat surface then deflate the mask cuff with a syringe.
Lubricate the back plate of the mask.
Make sure the patients head is in the “sniffing the morning air” position.
Insert the laryngeal mask along the hard and soft palate, guiding the mask through the natural bend in the airway until resistance is felt.
Create a seal by inflating the mask cuff and check the pressure.
Insert bite block vertically between molar teeth to achieve desired level of jaw opening ensuring the airway channel is on the medial surface. The airway tube of the laryngeal mask airway may be clicked into the channel on the bite block by pressing it laterally. To unlock the airway tube from the bite block, press the airway tube medially
To change sides. Unlock the airway tune (Press medially). Remove the bite block, rotate 180 degrees to ensure the airway channel remains on the medial surface and transfer to the opposite side and repeat step 7.
When waking the patient, the bite block may be placed in a horizontal position (dental groove superior) to prevent occlusion of the airway by patient biting down.