LMA Induction

Question 0

PRE-OXYGENATION ***
Open pop-off valve (1)
Apply tight mask seal (1)
Assure O2 flow meter >5 liters/min (1)
3 forced vital capacities within 30 seconds with 100% O2 (1)
3 minutes of 100% O2 with a goal of >85% end tidal oxygen concentration (1)

Answer 0

ADMINISTRATION OF DRUGS ***
Administer propofol (4)
Monitor for loss of lid reflex or ask patient to open eyes and take a deep breath (2)
Tape eyelids closed after loss of lid reflex (1)

Question 1

Complete machine check (1)
Complete equipment set-up (laryngoscope, ETT, airway, suction, LMA: cuff partially deflated and lubricated on non-vocal cord side) (1)
Complete medication check (1)

Answer 1

Apply pulse oximeter (1)
Apply ECG leads (1)
Apply NIBP (1)
Obtain baseline vital signs *** (4)

Question 2

Insert LMA (5)
Inflate LMA cuff to provide seal during hang bagging (3)

Answer 2

Connect to anesthesia machine circuit (2)
Partially close pop-off valve to prevent inspiratory pressures > 20 cm H2O (2)
Volatile agent on (4)
Auscultate chest bilaterally at mid-axillary line and epigastrum (1)
Tape LMA midline (2)
Choose spontaneous ventilation or PSV Pro ventilation (2)

Question 3

Adjust to proper settings (PEEP, pressure support) (1)
Turn on ventilator PSV Pro mode (2)
Bag/ventilator switch to ventilator (2)

Answer 3

Adjust fresh gas flows, typically 1 liter air and 1 liter O2 (1)
Volatile agent on (1)