22.7e Supraglottic Airway Devices

supraglottic airways

Laryngeal airways are (?).

laryngeal mask airway (LMA)

The (?) was the first laryngeal airway

patent

Because the (?) for this this device has expired, multiple similar devices are on the market.

OR setting

The LMA is commonly used in the (?) for selected cases.

EMS use

(?) was becoming widespread when this was the only supraglottic airway available.

more recently introduced extraglottic devices

Even though the original LMA is easily inserted, EMS use of it is now limited because it does not offer the features available in (?).

LMA Supreme

The? is an updated version of the LMA; it has several features that are very appealing for EMS use.

rigid design

It has a (?) that makes insertion easy without the need to place fingers in the mouth.

gastric decompression

The Supreme offers a very good seal against aspiration and facilitates (?) through a separate channel.

high airway pressures

It can also generate (?) when necessary to ventilate an obese patient or a patient with lung disease.

built-in bite block

Additionally, it has a (?) and a fixation tab that makes securing the device easy with a single strip of tape

decompression channel

Its primary disadvantages are that the (?) does not accommodate a gastric tube larger than 14 Fr, and blind intubation through the device is not possible.

LMA Fastrach

The (?) was the first intubating laryngeal airway designed to facilitate blind endotracheal intubation with a special tube or regular tube reverse loaded (i.e., with the curvature of the tube opposite to the curve of the device)

8.0-mm cuffed endotracheal tube

The device is a rigid, anatomically curved airway tube that is wide enough to accept an (?) and is short enough to ensure the cuff’s passage beyond the vocal cords.

rigid handle

The device has a (?) to facilitate insertion and adjustment of its position to enhance oxygenation and alignment with the glottis.

epiglottic elevating bar

An (?) in the mask aperture elevates the epiglottis as the ETT is passed through, and a ramp directs the tube centrally and anteriorly to reduce the risk of arytenoid trauma and esophageal placement.

excellent seal

The Fastrach has an (?) to protect against aspiration and generate high airway pressures when necessary.

extremely high success rates

Extensive studies in the OR setting have demonstrated (?) by users with minimal training even in obese patients and those with spinal precautions.

inability to decompress the stomach

Disadvantages include the (?), absence of sizes for patients less than 30 kg ideal body weight, and somewhat temperamental positioning for sustained bag-valve-mask ventilation.

air-Q

The (?) is another intubating laryngeal airway

pediatric sizes

In contrast to the Fastrach, the air-Q is available in (?) and looks much more like a traditional laryngeal airway.

endotracheal tube introducer

This shape allows intubation to be performed with an (?) and with direct tube placement.

major disadvantages

The (?) of the air-Q include the inability to decompress the stomach and the absence of literature validating the seal and success rates with blind intubation.

i-Gel

The (?) is a laryngeal mask that is becoming popular

variety of sizes

It comes in a (?); including multiple pediatric sizes.

built-in bite block

It has a (?) and a passageway that allows for the insertion of a gastric tube to decompress the stomach.

higher placement success rates

The large British cardiac arrest study showed much (?) for the i-Gel compared with intubation.