The laryngeal mask airway (LMA) has gained recognition as an acceptable device for securing the airway of patients during anaesthesia and emergency airway management within the hospital environment. Furthermore, the LMA has been utilised by paramedics in the prehospital setting when endotracheal intubation is either unavailable (untrained personnel) or impossible (failed intubation). Numerous articles have been published debating different techniques of its use and modifications from its original inception. This paper offers a recent review of those articles and presents a balance for the reader to consume. A brief history of the LMA is given, as well as discussion on selection of size, use of a bite block, cuff pressures, the disposable LMA, the intubating LMA, the ProSeal LMA and using cricoid pressure with the LMA insitu.
Cindy Hein, DipAppSc (Ambulance Studies), Bachelor Health Sciences (Paramedic), Ph.D., FACAP.
Cindy is an Intensive Care Paramedic with SA Ambulance Service (SAAS), and a casual Senior Lecturer in the Bachelor of Health Sciences (Paramedic) degree course at Flinders University in South Australia. In addition, Cindy is also an Advance Life Support (ALS) instructor (ARC), a representative of the Australian College of Ambulance Professionals (ACAP) on the ARC committee in South Australia, a member of the Flinders University Clinical Effectiveness area of strategic research investment, a reviewer for the Journal of Emergency Primary Health Care, and a Fellow of ACAP.
Completing a PhD in 2009, Cindy's research focussed on methods for improving teaching, retention, assessment and quality control of skills; particularly in relation to the use of extraglottic airway devices Laryngeal Mask Airway and the SLIPA (Streamlined Liner in the Pharynx Airway). Cindy's research agenda also includes further investigation into resuscitation outcomes.
Cindy has presented at several conferences, including: ACAP National Conferences (2004-2009), the American Society of Anaesthesiologists Annual Meeting in Las Vegas (2004), the Australian College of Operating Room Nurses, Adelaide, SA (2004), the EMS Today Conference & Expo, USA (2006), the Society in Europe for Simulation Applied to Medicine, UK (2008) and Ambex, UK (2008).
Australian Prehospital Emergency Health Research Forum Inaugural Best Paper Award at the ACAP National conference, Canberra, 2005.
Best Graduate Degree by Research Student Publication in the Journal of Emergency Primary Health Care, 2004.
Best Poster Presentation at the Australian Resuscitation Council Bi-annual conference, Gold Coast, 2004.
Hein C, Owen H, Plummer J. A proposed framework for deciding suitable extraglottic airway devices (EAD) for paramedics to use. Resuscitation. 2010;81(7):914-914.
Hein C, Owen H, Plummer J. A Training Program for Novice Paramedics Provides Initial Laryngeal Mask Airway Insertion Skill and Improves Skill Retention at 6 Months. Simulation in Healthcare. 2010;5(1):33-39.
Hein C, Owen H, Plummer J. A 12-month audit of Laryngeal Mask Airway (LMA) use in a South Australian ambulance service. Resuscitation, 2008;79(2):219-22.
Owen H, Hein C. Airway training devices. In: Riley R, editor. Manual of simulation in health care. New York: Oxford University Press; 2008.
Hein C. The EMS Today Conference & Expo - Baltimore, USA. Journal of Emergency Primary Health Care. 2006;4(2).
Hein C, Owen H, Plummer J. Randomised comparison of the SLIPATM, (Streamlined Liner of the Pharynx Airway), and the SS-LMTM (Soft Seal Laryngeal Mask) by medical students. Emergency Medicine Australasia. 2006;18(5-6):478-483.
Hein C, Plummer J, Owen H. Evaluation of the SLIPATM (Streamlined Liner of the Pharynx Airway), a single use supraglottic airway device in 60 anaesthetised patients undergoing minor surgical procedures. Anaesthesia and Intensive Care. 2005;33(6).
Hein C, Owen H. Effective application of cricoid pressure. Journal of Emergency Primary Health Care. 2005;3(1-2).
Hein C. The Prehospital Practitioner and the laryngeal mask airway: Are you keeping up?" Journal of Emergency Primary Health Care. 2004;2(1-2).
"The prehospital practitioner and the laryngeal mask airway: "Are you keeping up?","
Journal of Emergency Primary Health Care:
1, Article 11.
Available at: http://ro.ecu.edu.au/jephc/vol2/iss1/11