By Minh Le Cong
In this video Minh Le Cong (@ketaminh) discusses all things relating to supraglottic airways. As per the Vortex Approach to safe emergency airway management, a supraglottic airway is indicated when face mask ventilation and endotracheal intubation have failed. The most commonly used supraglottic airway is the Laryngeal Mask Airway (LMA), of which there are a number of different variations. The LMA is usually an effective, and minimally invasive airway device that can be life saving in an emergency setting or difficult airway. LMAs have the benefit of being easy to use with high success rates in unskilled operators, however as a last option before converting to an emergency surgical airway, it is essential to be able to troubleshoot a difficult supraglottic airway.
In this demonstration, Minh Le Cong first demonstrates using the LMA Classic. He describes the different airway maneuvers, device manipulations and adjunct tools that may assist with insertion. He then discusses an improvised technique for using an ETT as a supraglottic airway. Although it is not an ideal airway, this can be a useful temporary measure in an emergency if intubation is failing and a LMA is not available. It is particularly useful for paediatric patients. Finally, he discusses the use of the LMA Fastrach. This is a modified LMA designed to assist in difficult airway situations. It has the traditional LMA device with an additional handle and a the capacity for endotracheal intubation through the device. He demonstrates insertion of, intubation through and securing of the device.