Standards Procedure (Skill)
Clinical Indications: Level: EMT-P only
Ø Inability to secure an endotracheal tube in a patient who does not have a gag reflex where at least one failed intubation attempt has occurred.
Ø Appropriate intubation is impossible due to patient access or difficult airway anatomy.
Ø This airway does not prevent aspiration of stomach contents.
Clinical Contraindications:
Ø Pulmonary Fibrosis
Ø Morbid Obesity
Procedure:
a. Check the tube for proper inflation and deflation.
b. Lubricate with a water-soluble jelly.
c. Pre-Oxygenate the patient with 100% O2.
d. Insert the LMA into the hypopharynx until resistance is met.
e. Inflate the cuff until a seal is obtained.
f. Connect the LMA to an ambu bag and assess for breath sounds, air entry, and end-tidal CO2.
g. Monitor oxygen saturation with pulse oximetry and heart rhythm with ECG.
h. Re-verify LMA placement after every move of the patient and upon arrival at the emergency department.
i. Document the procedure, time, and results on the ACR.
Certification Requirements:
Successfully complete an annual skill evaluation including the indications, contraindications, technique, and possible complications of the procedure.