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Concept
Laryngeal mask airway
Summary
A laryngeal mask airway (LMA), also known as laryngeal mask, is a medical device that keeps a patient's airway open during anaesthesia or while they are unconscious. It is a type of supraglottic airway device. They are most commonly used by anaesthetists to channel oxygen or inhalational anaesthetic to the lungs during surgery and in the pre-hospital setting (for instance by paramedics and emergency medical technicians) for unconscious patients.
A laryngeal mask is composed of an airway tube that connects to an elliptical mask with a cuff which is inserted through the patient's mouth, down the windpipe, and once deployed forms an airtight seal on top the glottis (unlike tracheal tubes which pass through the glottis) allowing a secure airway to be managed by a health care provider.
The laryngeal mask was invented by British anaesthesiologist Archibald Brain in the early 1980s, and in December 1987 the first commercial laryngeal mask was made available in the United Kingdom. The laryngeal mask is still widely used today worldwide, and a variety of specialised laryngeal masks exist.
It channels oxygen and inhalational anaesthetic to the lungs. It can be used during anaesthesia, or while a patient is unconscious. Laryngeal mask airways are designed to be an easy way to secure the airway and ventilate a patient – they are easier to place than tracheal intubation due to the lack of muscle relaxants and laryngoscopy. They are also less likely to damage teeth or the larynx itself. It may form an air-tight seal. Cuffs are available in multiple sizes.
LMAs can be alternatives to the use of a face mask when using a bag-valve-mask device to prevent gastric insufflation.
A laryngeal mask airway is generally not used in surgeries where there is a high risk that stomach contents may be aspirated. This is particularly for surgeries that last longer than 2 hours. It often uses low inflation pressures, so may not be appropriate in patients with illnesses that cause low lung compliance.
Official source
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Tracheal tube
A tracheal tube is a catheter that is inserted into the trachea for the primary purpose of establishing and maintaining a patent airway and to ensure the adequate exchange of oxygen and carbon dioxide. Many different types of tracheal tubes are available, suited for different specific applications: An endotracheal tube is a specific type of tracheal tube that is nearly always inserted through the mouth (orotracheal) or nose (nasotracheal).
Airway management
Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere. This is accomplished by either clearing a previously obstructed airway; or by preventing airway obstruction in cases such as anaphylaxis, the obtunded patient, or medical sedation. Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents (aspiration).
General anaesthesia
General anaesthesia (UK) or general anesthesia (US) is a method of medically inducing loss of consciousness that renders a patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general anaesthetic medications, which often act in combination with an analgesic and neuromuscular blocking agent. Spontaneous ventilation is often inadequate during the procedure and intervention is often necessary to protect the airway.