LO5 Alternative airway devices Flashcards
The king LT Airway
single use single lumen airway device that is blindly inserted to provide positive pressure ventilation to apnoeic patients and to maintain a patent airway and unresponsive patients
The king LTSD is more commonly used device it is available in seven sizes that are based on the patient’s height and or weight
Indications for King LT airway
Alternative to bag mask ventilation when a rescue device is required for a failed intubation attempt
Indicated for airway management of deeply unresponsive apnoeic patient with no gag reflex and whom tracheal intubation is not possible or has failed
Contraindications for the king LT airway
Does not eliminate the risk of vomiting or aspiration
Do not use the king LT airway in patients with an intact gag reflex patients with known oesophageal disease or patients who have ingested a caustic substance
Complications of the king LT airway
Laryngeal spasm, vomiting and possible hyperventilation may occur
The laryngeal mask airway
It’s around the opening of the larynx with an inflatable silicone positioned in the hypopharynx
The laryngeal mask airway Indications and contraindications
Alternative to bag mask ventilation when the patient cannot be intubated
ineffective in patients with obesity and should not be used in morbidly obese
Ineffective for ventilation of patients requiring high pulmonary pressures
The laryngeal mask airway
dvantages and disadvantages
May provide better ventilation than a bag mask and does not require continual maintenance of mask seal
Easier and does not require laryngoscopy
Provides protection from upper airway secretions
Main disadvantage is that it does not provide protection against aspiration but increases the risk of aspiration
Complications of the LMA
The most significant complications associated with use of the LMA involve regurgitation and subsequent aspiration
Should only be used in patients who are fasting
—Meaning it cannot be used in emergency situations
The I-Gel
Supraglottic airway specifically designed to create non-inflatable anatomical seal of the pharyngeal and laryngeal anatomical structures while avoiding trauma
Allows passage of an NG tube to decompress the stomach and prevent regurgitation
Combitube
Multilumen airway device with a long tube that is inserted blindly into the airway
it is an alternative to tracheal intubation allows for better ventilation than a bag mask device and simple airway adjunct
It can function as a tracheal tube if inserted into the trachea
Combitube Indications and contraindications
Indicated for every management of deeply unresponsive, apnoeic patients with no gag reflex in whom tracheal intubation is not possible or has failed
Cannot be used in children younger than 16 years
Contraindicated in patients with oesophageal trauma, patients with known pathological conditions of the esophagus, patients who have ingested a caustic substance or patients who have a history of alcoholism
Combitube Advantages and disadvantages
It cannot be improperly placed
No mask seals required to ventilate
Provides patency to the airway
No upper airway positioning is required
Does not completely illuminate the risk of aspiration
Combitube complications
Significant complication is unrecognized displacement of the tube into the esophagus
Laryngeal spasm, vomiting, impossible hyperventilation may occur
Combitube consist of
a single tube with two lemons, two balloons and two ventilation ports one lumen is open at its distal and the other is closed
Combitube Insertion technique
Forwardly displace the jaw
insert device
Inflate the cuff:
ventilate the longer blue tube first if there are no breath sounds are epigastric sounds present the chest is not rise and fall during ventilation then switch immediately to the shorter clear tube
