This document discusses supraglottic airway devices. It begins by defining supraglottic airway devices as those that maintain airway patency by sitting just above the glottic opening without entering the trachea. It then classifies these devices based on generation, sealing mechanism, number of lumens, and other characteristics. Key devices discussed include the LMA Classic, Flexible LMA, ProSeal LMA, and Intubating LMA. Advantages and disadvantages of supraglottic airway devices are provided. Insertion techniques and signs of correct placement are also summarized.
This document discusses supraglottic airway devices. It begins by introducing supraglottic airway devices and their purpose of maintaining airway patency above the glottic opening. It then classifies supraglottic devices based on generation, sealing mechanism, number of lumens, and discusses some common devices like the LMA Classic, Unique, Flexible, and Ambu Aura. Indications, contraindications, advantages, disadvantages, proper sizing, insertion technique and signs of correct placement are outlined. Potential problems and methods to reduce aspiration are also reviewed.
This document discusses supraglottic airway devices. It begins by introducing supraglottic airway devices as those that maintain airway patency by sitting above the glottic opening. It then classifies devices based on generation, sealing mechanism, number of lumens, and discusses indications, contraindications, advantages, and disadvantages of supraglottic airway devices. Specific devices like LMA Classic, Flexible LMA, Ambu Aura, Soft Seal LMA, and Intubating LMA are then described in more detail. Problems associated with devices and techniques to reduce aspiration are also covered.
This document provides an overview of various supraglottic airway devices (SADs). It discusses the history and development of SADs including the laryngeal mask airway invented by Dr. Archie Brain in 1982. Various SADs are classified and their indications, contraindications, advantages, and disadvantages are outlined. Key SADs like the classic LMA, ProSeal LMA, LMA Unique, i-gel, and intubating laryngeal mask airway are described in more detail. Placement and securing techniques for SADs are also reviewed.
This document provides an overview of supraglottic airway devices including their history, classification, indications, complications, and techniques for insertion. Supraglottic devices such as the LMA were developed in the 1980s as an alternative to face masks and endotracheal tubes. They are now commonly used for airway management. Newer generations of devices like the ProSeal LMA provide improved ventilation and protection from aspiration compared to first generation devices like the Classic LMA. Proper selection of the device size and technique are important to ensure effective ventilation and prevent complications.
Laryngeal Mask Airway & Igel - An IntroductionHIRANGER
The document provides information about the Laryngeal Mask Airway (LMA) and I-gel devices for airway management:
[1] It discusses the indications, contraindications, equipment, and step-by-step process for inserting the LMA. Proper sizing, lubrication, and positioning are emphasized.
[2] Placement must be verified by ensuring equal breath sounds on both sides and absence of sounds over the epigastrium. Problems like improper deflation or folding can occur.
[3] The I-gel is introduced as a single-use, cuffless airway device with an integral gastric channel and epiglottis blocking ridge to facilitate insertion.
#Laryngoscopes face mask-airway & endotracheal tubesNisar Arain
This document discusses various types of face masks, airways, and laryngoscopes used in airway management. It describes different face masks including anatomical masks, Rendell-Baker-Soucek pediatric masks, and scented masks. It outlines techniques for using face masks and discusses complications. It also details oropharyngeal and nasopharyngeal airways including specific designs and insertion methods. Finally, it examines rigid and fiberoptic laryngoscopes, describing the components of handles and blades as well as different blade types like the Macintosh laryngoscope.
Face masks, laryngeal tube, airways yuvarajhavalprit
This document provides information about various airway devices used in anesthesia including face masks, oral and nasal airways, and laryngoscopes. It describes the parts, types, techniques of use, advantages and disadvantages of face masks. It also discusses oropharyngeal airways, nasopharyngeal airways, and different types of laryngoscope blades including Macintosh, Miller, and specialized blades. Complications of airway devices are also mentioned.
This document discusses supraglottic airway devices. It begins by introducing supraglottic airway devices and their purpose of maintaining airway patency above the glottic opening. It then classifies supraglottic devices based on generation, sealing mechanism, number of lumens, and discusses some common devices like the LMA Classic, Unique, Flexible, and Ambu Aura. Indications, contraindications, advantages, disadvantages, proper sizing, insertion technique and signs of correct placement are outlined. Potential problems and methods to reduce aspiration are also reviewed.
This document discusses supraglottic airway devices. It begins by introducing supraglottic airway devices as those that maintain airway patency by sitting above the glottic opening. It then classifies devices based on generation, sealing mechanism, number of lumens, and discusses indications, contraindications, advantages, and disadvantages of supraglottic airway devices. Specific devices like LMA Classic, Flexible LMA, Ambu Aura, Soft Seal LMA, and Intubating LMA are then described in more detail. Problems associated with devices and techniques to reduce aspiration are also covered.
This document provides an overview of various supraglottic airway devices (SADs). It discusses the history and development of SADs including the laryngeal mask airway invented by Dr. Archie Brain in 1982. Various SADs are classified and their indications, contraindications, advantages, and disadvantages are outlined. Key SADs like the classic LMA, ProSeal LMA, LMA Unique, i-gel, and intubating laryngeal mask airway are described in more detail. Placement and securing techniques for SADs are also reviewed.
This document provides an overview of supraglottic airway devices including their history, classification, indications, complications, and techniques for insertion. Supraglottic devices such as the LMA were developed in the 1980s as an alternative to face masks and endotracheal tubes. They are now commonly used for airway management. Newer generations of devices like the ProSeal LMA provide improved ventilation and protection from aspiration compared to first generation devices like the Classic LMA. Proper selection of the device size and technique are important to ensure effective ventilation and prevent complications.
Laryngeal Mask Airway & Igel - An IntroductionHIRANGER
The document provides information about the Laryngeal Mask Airway (LMA) and I-gel devices for airway management:
[1] It discusses the indications, contraindications, equipment, and step-by-step process for inserting the LMA. Proper sizing, lubrication, and positioning are emphasized.
[2] Placement must be verified by ensuring equal breath sounds on both sides and absence of sounds over the epigastrium. Problems like improper deflation or folding can occur.
[3] The I-gel is introduced as a single-use, cuffless airway device with an integral gastric channel and epiglottis blocking ridge to facilitate insertion.
#Laryngoscopes face mask-airway & endotracheal tubesNisar Arain
This document discusses various types of face masks, airways, and laryngoscopes used in airway management. It describes different face masks including anatomical masks, Rendell-Baker-Soucek pediatric masks, and scented masks. It outlines techniques for using face masks and discusses complications. It also details oropharyngeal and nasopharyngeal airways including specific designs and insertion methods. Finally, it examines rigid and fiberoptic laryngoscopes, describing the components of handles and blades as well as different blade types like the Macintosh laryngoscope.
Face masks, laryngeal tube, airways yuvarajhavalprit
This document provides information about various airway devices used in anesthesia including face masks, oral and nasal airways, and laryngoscopes. It describes the parts, types, techniques of use, advantages and disadvantages of face masks. It also discusses oropharyngeal airways, nasopharyngeal airways, and different types of laryngoscope blades including Macintosh, Miller, and specialized blades. Complications of airway devices are also mentioned.
The document discusses various airway management devices and techniques used in basic life support. It describes oropharyngeal airways, nasopharyngeal airways, laryngeal mask airways, endotracheal tubes, and difficult airway management devices like the Combitube. Guidelines for sizing and inserting these devices are provided, along with their indications, contraindications, and potential complications. Factors that can make intubation difficult are also outlined.
This document discusses various artificial airway devices used to maintain an open airway. It defines artificial airways as devices inserted into the respiratory tract to manage obstruction, facilitate ventilation of the lungs, and prevent obstruction. The document then proceeds to describe different airway devices in detail, including oropharyngeal airways, nasopharyngeal airways, endotracheal tubes, supraglottic airways like LMAs and Combitubes, and tracheostomies. It covers the purpose, usage considerations, advantages, disadvantages and proper technique for each type of artificial airway.
The document summarizes different types of supraglottic airway devices including their advantages, indications, and techniques for insertion and removal. It discusses the laryngeal mask airway (LMA) in detail, describing its design, sizes, and proper insertion technique. Other supraglottic devices covered include the LMA Fastrach, Proseal LMA, LMA-C Trach, I-gel, and LMA Supreme. Complications are also outlined. The document provides an overview of supraglottic airways for maintaining the airway.
- The laryngeal mask airway (LMA) is a supraglottic airway device that is placed in the hypopharynx to control the airway during general anesthesia or ventilation. It provides an alternative to endotracheal intubation or use of a face mask. The LMA has advantages like ease of insertion, reduced hemodynamic response, and improved oxygenation during emergence from anesthesia. Potential complications include sore throat, coughing, laryngospasm, and airway obstruction. Proper selection of size, lubrication, and insertion technique are important for successful use of the LMA.
- Supraglottic airway devices such as the laryngeal mask airway (LMA) provide an alternative to endotracheal intubation for maintaining a patient's airway during general anesthesia. The LMA is easy to place, improves cardiovascular stability, and allows for smooth induction and recovery compared to endotracheal intubation. Various types of LMAs have been developed with features like gastric drainage ports to reduce the risk of aspiration. Proper selection of the appropriately sized LMA and correct insertion technique are important for safely managing a patient's airway.
The document discusses various supraglottic airway devices used to maintain airway patency and provide ventilation without intubation. It begins with an introduction and history of supraglottic devices, then covers their classification based on generation, sealing mechanism, and number of lumens. Key devices described include the Laryngeal Mask Airway family (Classic, Unique, Flexible, Fastrach, CTrach, ProSeal, Supreme), Air-Q, laryngeal tube, and Combitube. Placement technique, signs of correct positioning, complications, and advantages/disadvantages of certain devices are summarized.
This document discusses techniques of mask ventilation. It begins by introducing mask ventilation as a noninvasive airway management technique used for short anesthetics or as a bridge to a more definitive airway. It then describes the types of face masks, including open masks for oxygen delivery and closed masks for ventilation. It discusses the parts of masks including the connector and harness. The document outlines techniques for mask application, including one-handed and two-handed techniques. It describes signs of inadequate mask ventilation and complications of mask ventilation such as skin allergy, nerve injury, gastric inflation, and eye or skin injuries. Throughout, it provides details on positioning, types of masks, application techniques, and complications to summarize techniques of mask ventilation.
This document discusses basic airway equipment used in anesthesia including face masks, airways, laryngeal mask airways, and endotracheal tubes. It describes the parts, materials, sizes, insertion techniques, advantages, disadvantages, and cleaning methods for each device. Common airway devices covered are the face mask, nasal airway, oropharyngeal airway, laryngeal mask airway (including Classic, ProSeal, and other types), and endotracheal tubes. Complications associated with each device are also summarized. The document provides an overview of basic airway management equipment.
ET TUBES presentation by Dr. Animesh Aman Singh19anisingh
Endotracheal tubes are inserted into the trachea to allow for ventilation of the lungs. They come in various sizes and materials. Ideal tubes are low cost, inert, and have smooth surfaces. Complications can occur from intubation like trauma, esophageal insertion, or misplacement. Tube size is based on patient age, height, or finger size. Position must be confirmed before use to ensure proper lung ventilation and prevent aspiration. Specialty tubes are made for specific situations like head and neck surgeries.
This document provides an overview of supraglottic airway devices. It discusses their history, classifications, indications, contraindications, complications and techniques. It describes some of the major devices including the Classic LMA, LMA Unique, Flexible LMA, LMA Fastrach, Air-Q, and LMA CTrach. Supraglottic devices are used to maintain airway patency and provide ventilation above the vocal cords. They have advantages over face masks and endotracheal tubes in certain situations but also have potential complications if not properly placed.
This document provides information on airway management techniques and equipment. It discusses preparation for intubation including equipment, patient positioning, and preoxygenation. It describes various airway adjuncts like oropharyngeal and nasopharyngeal airways. Intubation techniques including types of endotracheal tubes are explained. Difficult airway management strategies such as awake fiberoptic intubation are outlined. The document also covers ventilation, confirmation of tube placement, extubation, and references.
The document discusses the history and use of laryngeal mask airways (LMA). It describes how Dr. Brain developed the first LMA prototype in 1981 as a supraglottic device that sits outside the trachea but provides an airway. Over time, different types of LMAs were developed including the classic LMA, ProSeal LMA, reinforced LMA, LMA-Unique, and Supreme LMA. The document outlines the features and proper insertion technique for each LMA and discusses their advantages, such as being less invasive than endotracheal tubes, as well as potential complications if not properly placed.
This document provides an overview of pediatric airway management techniques. It discusses various oxygen delivery devices including nasal cannulas, simple oxygen masks, and non-rebreathing masks. Bag-valve mask ventilation is described including proper positioning and techniques. Intubation is covered, including equipment selection, laryngoscopy techniques, and confirmation of proper tube placement. Rescue airway devices like LMAs, Combitubes, and bougies are also summarized. Key rules for managing the pediatric airway emphasize being prepared, having backup plans, using common sense, and individualizing approaches for each patient.
This document provides information on basic airway management and obstruction. It discusses:
1. Causes of airway obstruction including decreased muscle tone, vomit, blood, and foreign bodies.
2. Methods for recognizing obstruction by listening for sounds, feeling for airflow, and observing chest and abdominal movement.
3. Techniques for managing obstruction including suction, head tilt/chin lift, jaw thrust, oropharyngeal and nasopharyngeal airways, pocket masks, and bag valve masks with or without added oxygen.
The document provides an overview of airway anatomy and management techniques. It describes the anatomy starting from the nose down to the trachea. It then discusses factors that can make the airway difficult and techniques for assessing the airway. It explains various airway management techniques including mask ventilation, use of airways, laryngoscopy, intubation, and alternative techniques like LMA and needle cricothyrotomy.
Supraglottic airway devices deliver gases above the vocal cords. The Laryngeal Mask Airway (LMA) was invented in 1981 and introduced improvements over prior extraglottic devices. There are now multiple versions of the LMA with variations in material, shape, and features. Proper selection and insertion technique are important for effective use of these airway devices.
This document discusses various airway equipment used in medical procedures. It describes different types of masks, supraglottic airways, laryngoscopes and other adjuncts used to secure and maintain a patient's airway. Key items mentioned include face masks, laryngeal mask airways, Magill forceps, Guedel airways, direct and rigid indirect laryngoscopes, bougies, stylets and endotracheal tubes. Advantages and disadvantages of different equipment are provided. Proper techniques for inserting supraglottic airways and using laryngoscopes are also outlined.
The document discusses several intermediate airway devices including the LMA (Laryngeal Mask Airway), Combitube, and King LT (Laryngeal Tube). The LMA is indicated for rescue airway management in patients with difficult mask ventilation or above-glottis bleeding. It is contraindicated in awake patients or those with distorted anatomy. Placement involves selecting the correct size and lubricating the device before inserting via the index finger technique. The Combitube and King LT are blind airway devices with dual lumens intended for use in cardiac arrest or failed intubation. Complications include aspiration and improper placement into the trachea instead of esophagus.
Supra glotic Airway Devices notes .pptxsravanray213
Supraglottic airway devices (SADs) such as laryngeal mask airways (LMAs) facilitate oxygenation and ventilation without endotracheal intubation by forming a seal around the laryngeal inlet. There are several types of SADs including the original LMA, ProSeal LMA, LMA Supreme, LMA Fastrach, laryngeal tubes, and more. They are made of silicone or thermoplastic materials and have inflatable or non-inflatable cuffs. SADs are inserted after the patient is anesthetized to maintain the airway and allow positive pressure ventilation. Placement must be correct for proper sealing and to avoid complications.
Potassium plays a crucial role in various physiological processes as an electrolyte and mineral. It helps maintain fluid, acid-base, and electrolyte balance. Potassium is also essential for nerve and muscle function, including the heart. It is involved in generating and transmitting nerve impulses, and regulating muscle contraction and relaxation. The kidneys play an important role in potassium balance by filtering it from the blood and excreting excess through urine. Abnormal potassium levels can disrupt these functions and cause adverse health effects.
Sodium plays several key roles in physiology. It is the main cation in extracellular fluid and helps maintain membrane potentials and nerve/muscle function. Sodium levels are tightly regulated by the kidneys through reabsorption and excretion and other factors like the renin-angiotensin-aldosterone system. Imbalances in sodium levels can cause hyponatremia or hypernatremia with neurological symptoms, so careful management is required.
More Related Content
Similar to supraglotticairwaydevice-150407110752-conversion-gate01.pptx
The document discusses various airway management devices and techniques used in basic life support. It describes oropharyngeal airways, nasopharyngeal airways, laryngeal mask airways, endotracheal tubes, and difficult airway management devices like the Combitube. Guidelines for sizing and inserting these devices are provided, along with their indications, contraindications, and potential complications. Factors that can make intubation difficult are also outlined.
This document discusses various artificial airway devices used to maintain an open airway. It defines artificial airways as devices inserted into the respiratory tract to manage obstruction, facilitate ventilation of the lungs, and prevent obstruction. The document then proceeds to describe different airway devices in detail, including oropharyngeal airways, nasopharyngeal airways, endotracheal tubes, supraglottic airways like LMAs and Combitubes, and tracheostomies. It covers the purpose, usage considerations, advantages, disadvantages and proper technique for each type of artificial airway.
The document summarizes different types of supraglottic airway devices including their advantages, indications, and techniques for insertion and removal. It discusses the laryngeal mask airway (LMA) in detail, describing its design, sizes, and proper insertion technique. Other supraglottic devices covered include the LMA Fastrach, Proseal LMA, LMA-C Trach, I-gel, and LMA Supreme. Complications are also outlined. The document provides an overview of supraglottic airways for maintaining the airway.
- The laryngeal mask airway (LMA) is a supraglottic airway device that is placed in the hypopharynx to control the airway during general anesthesia or ventilation. It provides an alternative to endotracheal intubation or use of a face mask. The LMA has advantages like ease of insertion, reduced hemodynamic response, and improved oxygenation during emergence from anesthesia. Potential complications include sore throat, coughing, laryngospasm, and airway obstruction. Proper selection of size, lubrication, and insertion technique are important for successful use of the LMA.
- Supraglottic airway devices such as the laryngeal mask airway (LMA) provide an alternative to endotracheal intubation for maintaining a patient's airway during general anesthesia. The LMA is easy to place, improves cardiovascular stability, and allows for smooth induction and recovery compared to endotracheal intubation. Various types of LMAs have been developed with features like gastric drainage ports to reduce the risk of aspiration. Proper selection of the appropriately sized LMA and correct insertion technique are important for safely managing a patient's airway.
The document discusses various supraglottic airway devices used to maintain airway patency and provide ventilation without intubation. It begins with an introduction and history of supraglottic devices, then covers their classification based on generation, sealing mechanism, and number of lumens. Key devices described include the Laryngeal Mask Airway family (Classic, Unique, Flexible, Fastrach, CTrach, ProSeal, Supreme), Air-Q, laryngeal tube, and Combitube. Placement technique, signs of correct positioning, complications, and advantages/disadvantages of certain devices are summarized.
This document discusses techniques of mask ventilation. It begins by introducing mask ventilation as a noninvasive airway management technique used for short anesthetics or as a bridge to a more definitive airway. It then describes the types of face masks, including open masks for oxygen delivery and closed masks for ventilation. It discusses the parts of masks including the connector and harness. The document outlines techniques for mask application, including one-handed and two-handed techniques. It describes signs of inadequate mask ventilation and complications of mask ventilation such as skin allergy, nerve injury, gastric inflation, and eye or skin injuries. Throughout, it provides details on positioning, types of masks, application techniques, and complications to summarize techniques of mask ventilation.
This document discusses basic airway equipment used in anesthesia including face masks, airways, laryngeal mask airways, and endotracheal tubes. It describes the parts, materials, sizes, insertion techniques, advantages, disadvantages, and cleaning methods for each device. Common airway devices covered are the face mask, nasal airway, oropharyngeal airway, laryngeal mask airway (including Classic, ProSeal, and other types), and endotracheal tubes. Complications associated with each device are also summarized. The document provides an overview of basic airway management equipment.
ET TUBES presentation by Dr. Animesh Aman Singh19anisingh
Endotracheal tubes are inserted into the trachea to allow for ventilation of the lungs. They come in various sizes and materials. Ideal tubes are low cost, inert, and have smooth surfaces. Complications can occur from intubation like trauma, esophageal insertion, or misplacement. Tube size is based on patient age, height, or finger size. Position must be confirmed before use to ensure proper lung ventilation and prevent aspiration. Specialty tubes are made for specific situations like head and neck surgeries.
This document provides an overview of supraglottic airway devices. It discusses their history, classifications, indications, contraindications, complications and techniques. It describes some of the major devices including the Classic LMA, LMA Unique, Flexible LMA, LMA Fastrach, Air-Q, and LMA CTrach. Supraglottic devices are used to maintain airway patency and provide ventilation above the vocal cords. They have advantages over face masks and endotracheal tubes in certain situations but also have potential complications if not properly placed.
This document provides information on airway management techniques and equipment. It discusses preparation for intubation including equipment, patient positioning, and preoxygenation. It describes various airway adjuncts like oropharyngeal and nasopharyngeal airways. Intubation techniques including types of endotracheal tubes are explained. Difficult airway management strategies such as awake fiberoptic intubation are outlined. The document also covers ventilation, confirmation of tube placement, extubation, and references.
The document discusses the history and use of laryngeal mask airways (LMA). It describes how Dr. Brain developed the first LMA prototype in 1981 as a supraglottic device that sits outside the trachea but provides an airway. Over time, different types of LMAs were developed including the classic LMA, ProSeal LMA, reinforced LMA, LMA-Unique, and Supreme LMA. The document outlines the features and proper insertion technique for each LMA and discusses their advantages, such as being less invasive than endotracheal tubes, as well as potential complications if not properly placed.
This document provides an overview of pediatric airway management techniques. It discusses various oxygen delivery devices including nasal cannulas, simple oxygen masks, and non-rebreathing masks. Bag-valve mask ventilation is described including proper positioning and techniques. Intubation is covered, including equipment selection, laryngoscopy techniques, and confirmation of proper tube placement. Rescue airway devices like LMAs, Combitubes, and bougies are also summarized. Key rules for managing the pediatric airway emphasize being prepared, having backup plans, using common sense, and individualizing approaches for each patient.
This document provides information on basic airway management and obstruction. It discusses:
1. Causes of airway obstruction including decreased muscle tone, vomit, blood, and foreign bodies.
2. Methods for recognizing obstruction by listening for sounds, feeling for airflow, and observing chest and abdominal movement.
3. Techniques for managing obstruction including suction, head tilt/chin lift, jaw thrust, oropharyngeal and nasopharyngeal airways, pocket masks, and bag valve masks with or without added oxygen.
The document provides an overview of airway anatomy and management techniques. It describes the anatomy starting from the nose down to the trachea. It then discusses factors that can make the airway difficult and techniques for assessing the airway. It explains various airway management techniques including mask ventilation, use of airways, laryngoscopy, intubation, and alternative techniques like LMA and needle cricothyrotomy.
Supraglottic airway devices deliver gases above the vocal cords. The Laryngeal Mask Airway (LMA) was invented in 1981 and introduced improvements over prior extraglottic devices. There are now multiple versions of the LMA with variations in material, shape, and features. Proper selection and insertion technique are important for effective use of these airway devices.
This document discusses various airway equipment used in medical procedures. It describes different types of masks, supraglottic airways, laryngoscopes and other adjuncts used to secure and maintain a patient's airway. Key items mentioned include face masks, laryngeal mask airways, Magill forceps, Guedel airways, direct and rigid indirect laryngoscopes, bougies, stylets and endotracheal tubes. Advantages and disadvantages of different equipment are provided. Proper techniques for inserting supraglottic airways and using laryngoscopes are also outlined.
The document discusses several intermediate airway devices including the LMA (Laryngeal Mask Airway), Combitube, and King LT (Laryngeal Tube). The LMA is indicated for rescue airway management in patients with difficult mask ventilation or above-glottis bleeding. It is contraindicated in awake patients or those with distorted anatomy. Placement involves selecting the correct size and lubricating the device before inserting via the index finger technique. The Combitube and King LT are blind airway devices with dual lumens intended for use in cardiac arrest or failed intubation. Complications include aspiration and improper placement into the trachea instead of esophagus.
Supra glotic Airway Devices notes .pptxsravanray213
Supraglottic airway devices (SADs) such as laryngeal mask airways (LMAs) facilitate oxygenation and ventilation without endotracheal intubation by forming a seal around the laryngeal inlet. There are several types of SADs including the original LMA, ProSeal LMA, LMA Supreme, LMA Fastrach, laryngeal tubes, and more. They are made of silicone or thermoplastic materials and have inflatable or non-inflatable cuffs. SADs are inserted after the patient is anesthetized to maintain the airway and allow positive pressure ventilation. Placement must be correct for proper sealing and to avoid complications.
Similar to supraglotticairwaydevice-150407110752-conversion-gate01.pptx (20)
Potassium plays a crucial role in various physiological processes as an electrolyte and mineral. It helps maintain fluid, acid-base, and electrolyte balance. Potassium is also essential for nerve and muscle function, including the heart. It is involved in generating and transmitting nerve impulses, and regulating muscle contraction and relaxation. The kidneys play an important role in potassium balance by filtering it from the blood and excreting excess through urine. Abnormal potassium levels can disrupt these functions and cause adverse health effects.
Sodium plays several key roles in physiology. It is the main cation in extracellular fluid and helps maintain membrane potentials and nerve/muscle function. Sodium levels are tightly regulated by the kidneys through reabsorption and excretion and other factors like the renin-angiotensin-aldosterone system. Imbalances in sodium levels can cause hyponatremia or hypernatremia with neurological symptoms, so careful management is required.
Hyponatremia is defined as a serum sodium concentration below 135 mEq/L. It is commonly seen in hospitalized patients and those with conditions like heart failure, cirrhosis, and SIADH. Treatment involves correcting the underlying cause and raising the serum sodium level, but too rapid of a correction can cause serious neurological complications. Tolvaptan is a vasopressin receptor antagonist that promotes water excretion without electrolyte loss, allowing for a safe correction of hyponatremia within 24-48 hours. Clinical trials demonstrated its ability to significantly increase serum sodium levels compared to placebo.
The document contains schedules for an annual planner spanning January through December, a more detailed January planner, and a sample weekly planner with times for scheduled activities broken out by day of the week and time slots. It provides templates for planning various events and activities over different time periods.
This calendar document shows the days of the week and dates for the month of January. It includes columns for the days of the week and dates along with spaces to write or type events for each day in the morning and afternoon. The days, dates, and time slots provide a structure for planning and scheduling activities throughout January.
The document contains schedules for weekly, monthly, and annual planning. The weekly schedule shows PowerPoint and design activities scheduled each hour between 10am and 5pm from Monday to Friday. The monthly schedule lists various project schedules and their contents from January 1st to 31st. The annual planner schedules 6 projects from January 2019 to December 2019.
This presentation provides tips for making effective presentations using awesome backgrounds to engage audiences and capture their attention. It discusses using backgrounds and features of Product A and Product B.
This document provides information on heat illnesses including heat rash, sunburn, heat cramps, heat exhaustion, and heat stroke. It details symptoms of each and recommends first aid treatments. Additional tips include drinking water regularly to avoid dehydration, resting in shade, and monitoring others for signs of heat stroke. Proper hydration is key to preventing heat illnesses, with recommendations to drink before thirst sets in and replace electrolytes through foods or sports drinks.
OCUUPATION RELATED RISK FACTORS FOR HEALTH.pptxMSrujanaDevi
2.9 billion workers worldwide are exposed to hazardous occupational risks that caused 775,000 deaths in 2000. The leading causes of death were unintentional injuries (41%), chronic obstructive pulmonary disease (40%), and lung cancer (13%). Occupational risks also accounted for a significant percentage of back pain, hearing loss, asthma, injuries, and leukemia. Common occupational risks include carcinogens, airborne particulates, noise, ergonomic stressors, and injury risks. Workplace disasters in the early 1900s, such as the 1911 Triangle Shirtwaist Factory fire that killed 146 workers, sparked legislation to better protect workers' safety and health.
This document provides guidelines for medical professionals on managing medicolegal cases. It discusses the duties of doctors towards patients and the state in such cases. Key points include registering medico-legal cases as early as possible, treating patient care as the top priority, properly documenting examination findings and sample collection, and being aware of relevant legal provisions around providing medical evidence.
This document outlines a project plan to increase volumes at Apollo Hospitals in Kakinada, India. The primary challenge is to increase volumes. The plan is to double profits in the second half of the year compared to the first half by identifying consultant doctors, conducting digital marketing campaigns, and hosting community outreach events. Challenges include a high number of below poverty line patients and competition from other hospitals in the area. Key performance indicators like inpatient volumes, outpatient volumes, scans, and health checks are benchmarked against targets for the third quarter.
This document provides information on drugs used for upper and lower respiratory infections. It discusses the anatomy of the respiratory tract and the process of respiration. For upper respiratory infections, it describes antihistamines, decongestants, intranasal glucocorticoids, antitussives, and expectorants. For lower respiratory disorders like asthma, it discusses beta-2 adrenergic agonists, anticholinergics, methylxanthine derivatives, leukotriene modifiers, glucocorticoids, cromolyn, and nedocromil. The document provides details on the mechanisms, uses, and side effects of these various drug classes.
This document discusses respiratory physiology and the management of respiratory conditions. It covers topics such as ventilation, gas exchange in the lungs, the cough reflex, treatments for cough including suppressants and expectorants, bronchodilators for conditions like asthma, and the adverse effects of medications like inhaled corticosteroids.
The document discusses several key terms related to cardiac output and heart function. It defines terms like contractility, preload, afterload, stroke volume, end diastolic volume, end systolic volume, cardiac reserve, and the Frank-Starling principle. It also examines how factors like heart rate, preload, afterload, and contractility can influence stroke volume and ultimately cardiac output.
The document discusses factors that regulate cardiac output, including preload, contractility, and afterload. It describes how the respiratory pump, cardiac pump, and muscle pump influence venous return and end-diastolic volume. The role of the sympathetic nervous system in increasing heart rate and contractility is explained. Methods for measuring cardiac output are outlined, including the Fick principle using oxygen consumption, indicator dilution techniques, thermodilution, and non-invasive methods like Doppler echocardiography and impedance cardiography. Disease states that increase or decrease cardiac output are briefly mentioned.
The document discusses cardiac output, including its definition as the amount of blood ejected by each ventricle per minute which is calculated as stroke volume multiplied by heart rate. It describes various methods to measure cardiac output based on Fick's principle and dye dilution, and factors that can cause cardiac output to vary such as age, sex, environment, exercise, and disease states. Physiological variations include increases with exercise, pregnancy, and environmental temperature, and decreases with cardiac conditions, arrhythmias, and hemorrhage.
This document outlines various methods for measuring cardiac output. It begins with a historical perspective on cardiac output measurement, noting that Adolf Fick first developed a technique for measuring it in 1870 using what is now called the Fick principle. The document then discusses the importance of cardiac output and ideal features of measurement devices. It describes both non-invasive techniques like echocardiography and invasive methods like thermodilution that use indicator dilution. The relationship between cardiac output, stroke volume, heart rate and cardiac reserve is also explained.
This document discusses drugs used to treat respiratory diseases like asthma. It describes the types and causes of asthma and the two main approaches to treatment: targeting bronchial smooth muscle tone and inhibiting inflammation. Bronchodilators like beta-agonists are used to increase adrenergic tone and relax smooth muscle. Corticosteroids, mast cell stabilizers, and other drugs target the inflammatory process. Treatment follows a stepwise approach based on asthma severity, starting with short-acting bronchodilators and adding controllers like inhaled corticosteroids as needed. Key drugs and their mechanisms of action are explained in detail.
This document discusses neuromuscular diseases, focusing on peripheral nerve disorders, motor neuron disease, and myopathies. It describes various types of polyneuropathies including diabetic, chronic inflammatory demyelinating, and hereditary neuropathies. Guillain-Barré syndrome is discussed as an example of an acute polyneuropathy. Evaluation methods like electromyography and nerve conduction studies are also summarized.
This document discusses pericardial diseases. It begins by defining the pericardium and its layers. The main types of pericardial syndromes encountered in clinical practice are then summarized as pericarditis, pericardial effusion, cardiac tamponade, constrictive pericarditis, and pericardial masses. Epidemiology, aetiology, classification, and specific syndromes like acute pericarditis are then explored in more detail over several sections. Therapies for different conditions are discussed, including acute pericarditis, recurrent pericarditis, and pericarditis associated with myocardial involvement.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
MATATAG CURRICULUM: ASSESSING THE READINESS OF ELEM. PUBLIC SCHOOL TEACHERS I...NelTorrente
In this research, it concludes that while the readiness of teachers in Caloocan City to implement the MATATAG Curriculum is generally positive, targeted efforts in professional development, resource distribution, support networks, and comprehensive preparation can address the existing gaps and ensure successful curriculum implementation.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
Thinking of getting a dog? Be aware that breeds like Pit Bulls, Rottweilers, and German Shepherds can be loyal and dangerous. Proper training and socialization are crucial to preventing aggressive behaviors. Ensure safety by understanding their needs and always supervising interactions. Stay safe, and enjoy your furry friends!
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
2. INTRODUCTION
▶ Devices that are used to maintain the airway patency and provide
ventilation by placing just above the glottic opening.
▶ They sit outside the trachea and provide a hands free means of gas
tight airway.
▶ Standard of airway management , filling the niche between
facemask and tracheal tubes.
▶ Dr
. Archie Brain developed LMA in 1982 as a modification of
Goldman dental mask with ETtube.
▶ The first commercially available supraglottic airway device was LMA-
Classic(1988).
3. CLASSIFICATION
▶ Based on Generation:-
LMA
First Generation
Simple airway device.
Low pressure
pharyngeal seal
May ormay not protect
from aspiration.
Have no specific design
to lessen the risk.
Eg.-
cLMA
Flexible LMA
All LMs
Laryngeal tube
Cobra perilaryngeal
airway
Second Generation
Specially designed for
safety.
High pressure pharyngeal
seal.
Reduce the risk of
aspiration.
May be more efficacious
in ventilation.
Eg.-
PLMA,
Supreme LMA,
Laryngeal tube suction 2,
Laryngeal tube suction D,
i-gel,
SLIPA.
4. CLASSIFICATION
▶ Based on sealing mechanism –
1.Cuffed perilaryngeal sealer:-
Non-directional non esophageal Sealers- cLMA, Flexible LMA, LMA
unique.
Directional Non-esophageal sealing- Fastrach LMA, ALMA.
Directional esophageal sealing- Proseal LMA, Suprem LMA.
2.Cuffed pharyngeal sealer:-
Without esophageal sealing:COPA, PAX.
With esophageal sealing:Combitube, L
T
,L
TS.
3.Cuff less preshaped sealer: -
With esophageal sealing- Baska mask, i-gel.
Without esophageal sealing- SLIPA , AirQ-SP
.
5. CLASSIFICATION
▶ BASED ON THE NUMBER OF LUMEN-
1.Single Lumen Devices:-
LMA-classic, LMA-unique, LMA-flexible, ILMA, C-trach, Soft seal,
Laryngeal Airway Device(LAD), Ambu Laryngeal Mask,
Pharyngeal airway express(PAX), Cobra Perilaryngeal
Airway(CPLA), Laryngeal Tube(LT), Cuffed oropharyngeal airway,
Stream Lined Liner of the Pharyngeal Airway(SLIPA), Glottic
Aperture Seal Device.
2.Double Lumen Devices:- Proseal LMA, Combitube, Laryngeal
Tube Suction(L
TS), Airway Management Device(AMD).
3.Tripple Lumen Devices:- Elisha Airway Device(EAD).
6. INDICATION
▶ Alternative airway during GA specially in short surgical
procedures and minor therapeutic or diagnostic procedures
like radiation therapy, diagnostic and interventional
radiology, endoscopy, ECTetc.
▶ Cardiopulmonary resuscitation to secure the airway.
▶ Essential part of difficult airway trolley.
▶ Primary airway device when urgent airway patency is
required in lateral position as lessertime required to place
LMA in the lateral position as against endotracheal intubation
in this position.
▶ Relative indication- in professional singers to avoid vocal cord
trauma.
7. CONTRAINDICATION
▶
▶
▶
▶
Limited mouth opening (<2 fingers)
Local pathology in pharynx , larynx or upperairway.
Trismus,facial or upper airway trauma
Increase risk of aspiration- Morbid obese, >14 week pregnant,
prior opiods medication, delayed gastric empting, acute
abdominal or thoracic injury, history of GERD, and hiatus hernia.
▶ Reduced lung compliance/increase work of breathing
8. ADVANTAGES
Increased speed and ease of
placement.
Less requirement of expertise.
Improved hemodynamic stability at
induction and during emergence of
anesthesia.
Minimal IOP and ICP changes during
insertion.
Increase airway tolerance.
Lowerfrequency of coughing during
emergence.
Improved oxygen saturation during
emergence
DISADVANTAGE
Inadequate positive
pressure ventilation.
More chances of aspiration
of gastric content.
Sore throat.
Vascularcompression and
nerve damage.
9. LMA- Classic
Comprised of three main components
– Airway T
ube
– Mask
– Inflation line
Maskdesigned to conform to the
contours of the hypopharynx with its
lumen facing the laryngeal opening.
Made of medical grade silicone, it
can be autoclaved and reused many
times.
Seal pressure =25cmH2O
10. SIZESELECTION
Mask Size Patient size /Body Weight Maximum Cuff
Inflation Volume (Air)
1 Neonates/Infants up to 5 kg Up to 4 mL
1.5 Infants 5–10 kg Up to 7 mL
2 Infants/Children 10–20 kg Up to 10 mL
2.5 Children 20–30 kg Up to 14 mL
3 Children 30–50 kg Up to 20 mL
4 Adults 50–70 kg Up to 30 mL
5 Adults 70–100 kg Up to 40 mL
6 Large Adults over 100 kg Up to 50 mL
11. PREPARATION PRIOR TO
INSERTION
▶ Select the propersize of LMA.
▶ Inspect the LMA for any tear , blockage .
▶ Slowly deflate the cuff to form a smooth flat wedge shape .
▶ Over inflate: look for leak.
▶ Use a water soluble lubricant to lubricate the posterior surface of LMA
just prior to insertion.
▶ Avoid excessive amounts of lubricant
-on the anterior surface of the cuff or
-in the bowl of the mask.
Avoid lignocaine jelly for lubrication .
12. INSERTION TECHNIQUE
▶ Position: Neck flexed and head extended.
▶ Use non-inserting hand to stabilize occiput.
▶ Jaw should be pulled down by assistant.
▶ LMA tube be grasped like a pen with index
finger pressing the point where tube joins
mask.
▶ Place the tip of the LMA against the inner surface
of the patient’s upper teeth.
▶ Aperture facing forward, the tip pressed
upwards against the hard palate.
▶ Mask is advanced into pharynx to ensure
that tip remains flattened and avoids the
tongue.
13. Continue..
▶ Neck iskept flexed and head extended.
▶ Press the mask into the posterior pharyngeal wall
using the index finger.
▶ Continue pushing with your index finger and
guide the mask downward into position.
▶ Grasp the tube firmly with the other hand and
then withdraw your index finger from the
pharynx.
▶ Press gently downward with your other hand to
ensure the mask is fully inserted.
14. Continue..
▶ Inflate the mask with the
recommended volume of air
.
▶ Do not over-inflate the LMA.
▶ Normally the mask should be
allowed to rise up slightly out of the
hypo pharynx as it isinflated to find
itscorrect position.
▶ Inserta bite-block or roll of gauze to
prevent occlusion of the tube.
▶ Now the LMA can be secured
utilizing the same techniques as
those employed in the securing of
an endotracheal tube.
15. OTHER METHODS OF
INSERTION
▶ 1. Thumb index method.
▶ 2.Partial inflation method.
▶ 3.180 degree rotation method.
▶ 4.Laryngoscopy aided method.
▶ 5.Stylet aided method.
▶ 6.Insertion from the side of the mouth opening.
16. SIGNS OF
CORRECT
PLACEMENT
The slight outward movement of the tube
upon LMA inflation.
The presence of a smooth oval swelling in
the neck around the thyroid and cricoid
area, or no cuff visible in oral cavity.
Ventilate the patient while confirming equal
breath sounds over both lungs in all fields
and the absence of ventilatory sounds over
the epigastrium.
Part of LMA Position
Distal tip of
silicone cuff
Upper esophageal
sphinter
Sides of the cuff Pyriform fossa
Upper part of the cuff Tounge base
17. PROBLEMS
▶ Failure to press the deflated mask up against
the hard palate or inadequate lubrication or
deflation can cause the mask tip to fold back on
itself.
▶ Once the mask tip has started to fold over, this
may progress, pushing the epiglottis into its
down-folded position causing mechanical
obstruction .
▶ If the mask tip is deflated forward it can push
down the epiglottis causing obstruction
▶ If the mask is inadequately deflated it may
either
▶ push down the epiglottis
▶ enter the glottis.
18. INTUBATION WITHC-LMA
▶ 1.Blind intubation.
▶ 2.Fibrescope guided.
▶ 3.retrograde.
▶ 4.Lighted stylet guided.
▶ 5.Nasotracheal intubation.
DISADVANTAGES:-
1.Standard tube not long enough to insert.
2.Pilot tube may kincked.
3.Cricoid pressure make it difficult to pass the tube.
4.Paediatric-largest uncuffed tube too small to allow good seal for
PPV.
5.Removal of the LMA disturbs the ETtube
6. PPV not always possible due to moderate pharyngeal seal.
7.More riskof aspiration
19. Steps to reduce the chance
of aspiration
Routinely test the cuff for defects before
use.
Avoid lubricating the anterior surface of
the mask, since the lubricant may be
aspirated.
Insert the LMA only when adequate
depth of anesthesia has been reached.
Avoid disturbing the patient during
emergence from anesthesia.
Keep the cuff inflated till the patient is
awake.
Action after aspiration
Avoid in patients who are un-fasted, or
have factors predispose to regurgitation. 1. Do not attempt to remove
LMA.
2. Disconnect the circuit and
allow to drain the fluid while
head isdown & to the side.
3. Suction the LMA & give 100%
O2.
4. Ventilate manually with low
gas flow & small TV
.
5. Evaluate tracheobronchial
tree & suction the remaining
fluid with FOB.
6. Intubate when aspiration
below vocal cords.
20. LMA - UNIQUE
▶ Single use , PVC made ,
cheaper.
▶ Tube –stiffer , Cuff-less
compliant.
▶ Less rise of intracuff presuure
with N2O.
▶ More difficult to insert.
▶ Size same as cLMA.
21. FLEXIBLE LMA
▶ Flexometallic tube- narrower & longer.
▶ Has a rigid preformed angle at the cuff.
▶ Seal pressure=20cmH2O
▶ More difficult to insert.
▶ Introducer helps to stabilize the airway tube
during insertion & it is removed once mask is
in place.
▶ It has a less incidence of dislodgement once
placed.
▶ More useful in head & neck surgeries, ENT and
upper torso procedures where need to
reposition the airway is prevalent
▶ Problems-Disruption of spiral reinforce
wire, Increased airway resistance , limits
endoscope & tracheal tube passage ,
unsuitable forMRI.
22. AMBU AURA LARYNGEAL
MASK
▶ Ambu Auraonce- single-use LM with a
preformed curve.
▶ T
he Ambu Aura40 isthe reusable, silicone
version of the Ambu AuraOnce.
▶ The Ambu Aura-i designed to facilitate
intubation like ILMA.
▶ Three parts- an airway tube, a mount area,
and a bowl including the inflatable cuff..
▶ All these three areas are molded as single
unit for extra safety -no separation..
▶ Facilitate insertion without exerting force on
the upper jaw in neutral position.
▶ A reinforced tip reduces the risk of the
device folding back during insertion.
▶ integrated inflation line and no epiglottic
barsat the airway orifice.
23. SOFT SEAL LARYNGEAL MASK
▶ similar to the single-use LMA.
▶ The ventilation orifice iswider and it is
characterized by the absence of mask
aperture bars.
▶ Cuff ismore elliptical.
▶ insertion with the cuff partially inflated is
recommended.
▶ A maximum intracuff pressure of 60 cm
H2O isrecommended.
▶ may be used as an intubation conduit.
▶ The large bowl of the device and itsPVC
Construction inhibit easy insertion.
24. PERILARYNGEAL AIRWAY
⚫ single use, PVC made, latex free .
⚫ Ithas a breathing tube with a large inner
diameter to increase air flow.
⚫ Inthe proximal end it has a standard 15 mm
connection
⚫ Novel head design- Grill of soft bar with Cobra
head shape.
▶ Lies infront of laryngeal inlet.
▶ T
ip deflects epiglottis.
▶ Bars allow ventilation & instrumentation.
▶ Internal ramp to guide ETTto wards glottis
Proximal high volume low pressure cuff- seals
hypopharynx.
PLA offers a more effective seal, and a better
fiberoptic score as the c-LMA.
25. ADVANTAGES
1. Easy to insert.
2. Large lumen allows larger ETT&
fibrescope.
3. Sealing pressure higherthan C-
LMA.
4. Can be used forparcutaneous
dilatational cricothyroidotomy.
DISADVANTAGES
1. Less airway protection –
as tip liesabove the
oesophageal inlet.
2. Airway obstruction.
26. INTUBATING
LARYNGEAL
AIRWAY
▶ medical-grade silicon and latexfree.
▶ airway tube iscurved similar to the
anatomical curve of the upperairway
to eliminate the need to bend the tube
furtherduring use, which can lead to
kinking.
▶ Mask-keyhole outlet to direct ETTto
laryngeal inlet.
▶ 3 ridges –on inflation of mask, these
ridges move against the posterior
pharynx and improve anteriormask
seal.
▶ After intubation , ILA can be removed
without dislodging the ETTusing a
reusable "ILARemoval Stylet”.
▶ Low airway seal, high risk of aspiration.
27. INTUBATING LMA
▶ A modification of the c-LMA.
▶ A rigid (stainless steel) anatomically
curved,short & wide bored shaft that
followsthe anatomical curve of the palate
and the post pharyngeal wall.
▶ An epiglottic elevator bar at the mask
aperture
▶ Armoured flexible ETtube with a
longitudinal and a horizontal black line-
coincides with the epiglottic elevating bar.
▶ T
he StabilizerRod of 25cm.
▶ Seal pressure=60cmof H2O max.
Body
weight
ILMA size Air
volume
Tracheal
Tube
30-50kg 3 20ml 7mm
50-70kg 4 30ml 7.5mm
70-100kg 5 40ml 8mm
28. INSERTION
▶ Position: Neutral
▶ Hold rigid handle parallel to patient’s chest.
▶ Glide the mask along the palate till the straight part of the rigid tube is
parallel to the chin.
▶ Rotate the rigid handle directing towards patient’s nose till it can not
be advanced.
▶ Inflate the cuff & check ventilation.
▶ Introduce FETTwith black line faceing rigid handle till 15 cm mark.
▶ Now grip ILMA handle firmly and lift it forward by few mms without
levering.
▶ Advance the tube using clinical judgment.
▶ Inflate the cuff and check for tracheal intubation.
29. Continue..
▶ After confirmation of tracheal intubation deflate the ILMA cuff.
▶ Remove FETTconnector
▶ Insert the stabilizing rod in the FETTto keep it in place.
▶ Remove the ILMA gently over the stabilizing rod until it is clear of the
oral cavity.
▶ Stablize the FETTto prevent accidental extubation.
▶ Remove ILMA and the stabilizing rod.
▶ Reconnect FETTconnector and the breathing circuit and
▶ confirm position again
30. CHANDY’S MANEUVER
▶ They increases the seal pressure and aligns the axes of trachea and
FETT
.
▶ First step :Rotating ILMA in coronal & sagittal plane in an attempt to
find least resistant ventilation position.
▶ Second step :is to grasp the handle and use it to draw LMA forward
2-5 mm in a lifting action without levering teeth.
31. ADVANTAGES
⚫ Useful in “can’t intubate, can’t
ventilate” scenarios.
⚫ Allows fast insertion into correct
position without moving patient’s
head or neck.
⚫ Can be used alone or as a guide to
intubation.
⚫ Facilitates ventilation between ILMA
insertion and ETT insertion
⚫ Good conduit for fibreoptic
intubation in presence of blood or
clot in oral cavity.
⚫ Difficult laryngoscopic view is
irrelevent to the success of ILMA
intubation.
DISADVANTAGES
More likely to dislodge in head or
neck manipulation.
Unsuitable forMRI.
Difficulty in insertion with limited
mouth opening.
On removal of ILMA , tracheal tube
can be displaced downwards.
32. PROSEAL LMA
▶ Reusable , silicon made , most
specialized modification of c-LMA.
▶ Modifications:-
(i)oesophageal drain tube
(ii)posteriorinflatable cuff
(iii)reinforced airway tube
(iv) integral bite block
(v)introducer
Higherleak pressure(35cm of H2O)
than c-LMA(25cm of H2O).
Size-in 7 sizes(1-5) like the C-LMA with
drainage tube of
8,10,10,14,16,16&18 Fr respectively.
33. INSERTION
▶ (i) Standard: identical to the cLMA, but demanding
careful attention to detail.
▶ (ii) Introducer: a metal introducer is attached to
the concave side of the device. It is then
introduced in the same manner as an intubating
LMA.
▶ (iii) Bougie-guided: a bougie is placed upside down
into the oesophagus and the PLMA is railroaded
into place via the drain tube (suction catheters or
orogastric tubes are alternatives).This technique
had a significantly higher success rate.
▶ Positioning:- The easy passage of an orogastric
tube into the stomach via the oesophageal
tube has been shown to correlate with optimal
anatomical airway positioning over the larynx.
34. ADVANTAGES
▶ Increased airway seal improves the PPV.
▶ Decreased chance of aspiration-
1.Oesophageal opening isisolated from the airway.
2.Drain tube vents gas leaked into the oesophagus.
3.On regurgitation drain tube vents the fluid & small solid particles
beyond the pharynx.
4.The large bulk of the PLMA reduces the space available for
regurgitated fluid to ‘pool’.
5. Increased oesophageal and pharyngeal seal decreases the risk
of any pooled fluid entering the laryngeal inlet.
▶ Simple tests enable correct positioning of the PLMA to be confirmed.
▶ The stomach may be accessed with an orogastric tube.
35. DISADVANTAGES
▶ 1. Less suitable as an intubating device as an ILMA b/c narrow
airway tube.
▶ 2.Slightly longer time required to insert than C-LMA.
▶ 3.Can cause airway obstruction by- compression of supraglottic
structure or cuff in folding.
▶ 4.Contraindicated for intraoral surgery .
36. LMA - SUPREME
▶ Single use, PVC made 2nd
generation LMA.
▶ Has features of P-LMA, I-LMA & LMA
unique.
(i) Single use , PVC- (cf.LMA unique).
(ii)Large inflatable plastic cuff, but
no posteriorcuff (cf. PLMA)
(iii)Oesophageal drain tube
(iv)Preformed semi-rigid tube
(v)Fins in the mask bowl to prevent
epiglottic obstruction(cf. PLMA,
cLMA)
▶ Pharyngeal seal isintermediate
between cLMA and PLMA( 26–30
cm H2O)
▶ Oesophageal seal not reported.
37.
38. ADVANTAGES
The reinforced tip reduces the risk
of fold-over
, compared with the
PLMA.
Anatomic curve that facilitates
easy insertion.
A drain tube to allow gastric
which generates higher seal
pressure (36.1 vs 27.4cm H20 of
LMA unique).
▶ A built-in bite block and fixation
tab to help secure the airway
▶ 4- An oval airway crosssection
forimproved stability of the
airway
DISADVANTAGES
drain tube runs through the middle
of the airway tube (rather than
next to it in the PLMA) dividing it
into two narrow lumens.This limits
itsuse forairway inspection
aspiration. and foruse as a conduit for
▶ A high volume/ low pressure cuff intubation.
Being made of PVC, the SLMA
may cause more trauma than
silicone devices
39. LMA C Trach
• The LMA CTrach system is a new system for
airway management and endotracheal
intubation.
• It is based on the ILMA (LMA Fastrach)
system with two in-built fiberoptic channels,
one to convey light from and the other to
convey the image to the viewer.
• This fiberoptic system is sealed and robust,
and the Ctrach can be autoclaved.
• The CTrach has an epiglottis elevating bar,
which elevates the epiglottis during passage
of the ETT through the Ctrach into the
larynx.
• A rechargeable battery is provided for up to
30 minutes of continuous use. A charger
cradle for recharging the viewer is included
in the system
40. LMA C-Trach
▶ Enables combined ventilation,
visualization, and intubation.
⚫ High first attempt intubation success rate
of 91%
.
⚫ Fiberoptic technology allows real time
visualization of the glottic opening and
of the ETtube passing through the vocal
cords.
⚫ Ideal in rescue/difficult airway situations
⚫ Completely portable and wirelesssystem
weighs less than eight ounces.
⚫ Easy to learn and very effective
41. INSERTION
▶ Inserted exactly the same as the LMA Fastrach.
▶ Once the airway is secured and patient is being ventilated
▶ The viewer is switched on, placed in the magnetic connector and a clear
image of the larynx is displayed in real time.
▶ The ET tube can be viewed as it enters the trachea. Once the patient is
intubated, the viewer is removed and the mask is removed leaving the ET
tube in place.
▶ Problems:-
1. Ithas a poorer image quality than a flexible fiberoptic endoscope.
2.Itcannot be used easily in the patient with a limited mouth
opening.
3. The view may be obstructed by secretions, lubricant, or blood.
42. i-GEL
▶ Novel SAD designed by UK anaesthetist,
Muhammed Nasir
.
▶ (i) Single use.
▶ (ii) Cuffless:the mask ismade of a soft
polymer and isshaped similarly to an
inflated LMA posteriorly with itsanterior
shape designed to ‘fit the perilaryngeal
structures’.
▶ (iii) Narrow-bore oesophageal drain
tube.
▶ (iv) Short, wide-bore airway tube.
▶ (v) Integral bite block
▶ (vi) Contains an epiglottic rest at the
anteriorpart of the cuff which reduces
the possibility of epiglottis ‘down folding’
and airway obstruction.
43.
44. Continue…
▶ Mask ismade of a thermoplastic elastomer (SEBS-StyreneEthylene
Butadiene Styrene) that has the flexibility and feel of human tissue. .
After placement, body heat from the patient activates the gel component of
this airway which expands to fill the void in the hypopharynx where the
device rests.
Advantages:-
▶ 1. easy to insert: due to a combination of a very,very low coefficient
of friction when lubricated & absence of cuff.
▶ 2. truncated tip, with the aim of reducing post-use dysphagia.
▶ 3. wide lumen make it well worth for both airway rescue and as a
conduit forassisted intubation.
▶ 4. A gastric channel allows for suctioning and placement of a
nasogastric tube.
▶ 5.Though oesophageal seal islow but enough (according to the
manufacturer).
45. LARYNGEAL TUBE
multiuse, latex-free, single-
lumen silicon tube
two low pressure cuffs
(proximal and distal).
▶ The distal balloon
(esophageal balloon) seals
the airway distally
▶ The proximal balloon
(oropharyngeal balloon)
sealsboth the oral and nasal
cavity.
▶ Two anterior,oval ventilating
ventsbetween the cuffs.
▶ Cough pressure 60cmH2O
▶ 4 types-L
T
,L
T
-D, L
TS-II, L
T
s-D
46.
47. INSERTION
▶ Open the mouth app. 3 cm using
the thumb and index finger
technique in neutral position of
head.
▶ Hold like a pen in the area of the
teeth marks(three black marks).
▶ Insert centrally along the hard
palate into the hypopharynx.
▶ Advance until a slight resistance is
felt. The center black line should n
be level with the upper front teeth.
▶ Inflate the cuffs considering the
respective colour code.
▶ Connect bag to the 15 mm
standard connector.
▶ place the tube deeper, inflate the
cuffsand withdraw until ventilation
isoptimized results in the best depth
of insertion because tissue is
retracted away from the laryngeal
inlet.
49. ADVANTAGES
1. Easy insertion.
2. 2.High ventilation pressure can
be used.
3. Better protection from
aspiration.
4. Can be used to intubate the
trachea.
DISADVANTAGES
1.Airway obstruction.
2.Displacement on head &
neck movement.
3. Cuff rupture
4. T
rauma to pharynx.
50. ESOPAHGEAL- TRACHEAL
COMBITUBE
▶ PVC double lumen supraglottic
airway device with two inflatable
balloons
▶ 2 Lumens:tracheal and pharyngeal
▶ Ventilation -eithertracheal or
esophageal intubation
▶ 95%of casestube enters the
esophagus
▶ Proximal balloon-seals the oral and
the nasal cavity
▶ Distal balloon - sealseitherthe
esophagus or the trachea,
depending on which of these the
ETC has been sited.
▶ Size-37 Fr for height up to 5 ft.
▶ 41 Fr for height above 5.5 ft.
▶ Between 5-5.5ft – either of these.
51. INSERTION
▶ Neutral position. Lift the tongue and
lower jaw upward to open the
oropharynx .
▶ Lubricate the tube with sterile, water
soluble lubricant.
▶ Insert the Combitube so that it curves in
the same direction as the natural
curvature of the pharynx .
▶ If resistance ismet, withdraw tube and
attempt to reinsert.
▶ Advance tube until the patient’s teeth
are between the two black lines.
▶ Inflate the blue pilot cuff with 100ml of
airfrom the large syringe.
▶ Inflate the white pilot cuff with 15ml of
airfrom the small syringe.
▶ Begin ventilation through the longer
tube . If auscultation of breath sounds is
good and gastric inflation isnegative,
continue and vice versa.
52.
53. INDICATION
1. Patientsin irreversible
respiratory arrest (i.e.
narcotic overdose,
hypoglycemia).
2. Patientsin cardiac arrest.
3. Ventilation in
normal/abnormal airways
4. Failed intubation
5. Unconscious patientswithout
a gag reflex, and in need of
ventilatory support
CONTRAINDICATION
1. Intact gag reflex
2. Under 4 feet tall & Under 16
years of age
3. Conscious –arouseable
patient
4. Known esophageal disease
(cancer, varices)
5. Ingestion of caustic
substances
6. Stoma or functional surgical
airway
7. Partial or complete FBAO
8. CONS
IDER:Latex Allergy
54. ADVANTAGES
1. Requires minimal training
2. May be more useful in non-
fasted patients
3. Successful passage and
ventilation in many patients via
esophageal route
4. Portable, useful in remote
setting
5. Functions in eitherthe trachea
or esophagus
DISADVANTAGES
1. Only adult and small adult
sizes
2. Potential foresophageal
trauma
3. Problems maintaining
seal in some patients
55. EASY TUBE
▶ The Easy Tube isnew disposable,
polyvinyl -chloride, double-lumen,
latex-free, supra-glottic airway
device.
▶ It has a close design to the
Combitube, intended to be more
friendly to use.
▶ Allows ventilation in either
esophageal or tracheal position,
however it isexpected to enter the
esophagus in most cases.
▶ However, the Easy Tube had a better
fiberoptic view and a shorter time to
achieve an effective airway, with
similar ventilatory performanceswith
the ETC
56. STREAMLINED LINEROF
THE PHARYNGEAL
AIRWAY
.
▶ Plastic made, uncuffed, disposable ,2nd
generation SAD.
▶ Anatomically pre-shaped to line the
pharynx.
▶ Hollow & boot shaped distal part-
1
. T
oe- rest in the oesophageal entrance
2. Bridge- fits to the pyriform fossa.
3. Heel- anchor in correct position &
connect the airway tube.
4
. T
wo lateral bulges- relieve pressure on
Hypoglossal& recurrent laryngeal NV.
5. Large capacity chamber-store
regurgited fluid.
Available in 6 sizes- relate to dimension
across the bridge: 47, 49, 51, 53, 55, and
57 mm.
57. ADVANTAGES
1. Easy to insert.
2. Greater airway sealing pressure.
3. N2O has no effect on sealing
pressure-as no cuff.
4. Effective protection against
aspiration during PPV
CONTRAINDICATED
Upperairway
abnormality.
58. CUFFED OROPHARYNGEAL
AIRWAY
⚫ PVC made , single use ,1st generation.
▶ The distal cuff inflate below the soft
palate, behind the tongue,above the
epiglottis, and within the oropharynx.
▶ Available in five sizes: 7, 8, 9, 10, and 11
cm length with cuff inflation volume of 20,
25, 30, 35, and 40 ml respectively.
▶ Insertion like Gudel’s oropharyngeal
airway.
▶ COPA isrecommended foruse in
spontaneously breathing patients with no
risk factorsforaspiration.
⚫ It isquick and easy to place.
⚫ Easy size selection & low cost.
⚫ Less airway protection
59. ELISHA AIRWAY DEVICE
▶ Silicon made , latex free, latest.
▶ three separate channelsforventilation,
intubation, and gastric tube insertion.
▶ Ventilation channel (VC) and
Intubation channel (IC) are side-by-side
but join at the ventilation outlet situated
in front of the laryngeal inlet.
▶ The VC has a standard 15 mm
connector at th proximal end.
▶ The IC allows passage of an 8.0 mm ET
tube forblind orfiberoptic-guided
intubation.
▶ Gastric tube channel (GTC) has an
outlet located in the distal end of the
device.
60. ▶ Two high-volume, low-pressure cuffs.
▶ Proximal cuff seals the oropharynx and nasopharynx & distal
cuff sealsesophagus.
▶ Both are inflated through a single pilot port with 50 cc of air
resulting in an intra-balloon pressure of approximately 70 cm
H2O.
▶ Provide combination of 3 functions in a single device:
ventilation, intubation (blind and/or fiberoptic-aided) without
interruption of ventilation, and gastric tube insertion.
61. OTHER NEWER SAD
▶ EldorLaryngeal Airway.
▶ Glottic Aperture Seal Airway.
▶ Glossopalatine Tube. Etc.
62. EFFICACY VS SAFETY
▶ For the evaluation of efficacy (absolute & relative ) small clinical
trialscan be used.
▶ Contrary, evaluations of safety (like ventilation failure rates , more
pertinently the risk of aspiration ) may need studies in larger scale
with larger populations.
▶ Therefore the risk profile of a new device (unless it is particularly
unsafe) isunlikely to be established for several years after
introduction.
63. SUMMARY
▶ There is no solid evidence of any device performing better than
the classic LMA among the first generation SADs.
▶ In the second-generation SADs-The PLMA proved top be very
efficacious and safe in both routine and advanced uses
▶ SAD with a drain tube has become the first choice as the
standard of care.
▶ OthernewerSADs like i-gel, SLMA, and L
TS-IIhave increasing
positive evidence of their superiority.
▶ All these developments in the field of SAD paved the way to take
an ever larger role in modern airway management.