The Laryngeal Mask Airway at Altitude

Abstract The Laryngeal Mask Airway (LMA) is an accepted adjunct for airway management in emergency patients. There are a number of case reports describing its use in transport medicine for infant to adult patients, including during flight. Although studies of the effect altitude has on air-filled tr...

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Bibliographic Details
Published in:The Journal of emergency medicine 2008-02, Vol.34 (2), p.171-174
Main Authors: Wilson, Grant D., RRT, Sittig, Steven E., RRT, Schears, Gregory J., MD
Format: Article
Language:English
Subjects:
Adult
Aerospace Medicine
Air Ambulances
air medical transport
Air Pressure
Altitude
Emergency
Humans
Infant
Laryngeal Mask Airway
Laryngeal Masks
LMA cuff
Manikins
over inflation
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Summary:Abstract The Laryngeal Mask Airway (LMA) is an accepted adjunct for airway management in emergency patients. There are a number of case reports describing its use in transport medicine for infant to adult patients, including during flight. Although studies of the effect altitude has on air-filled tracheal tubes exists, we were unable to find documentation of the effect of altitude on laryngeal mask airways. Our objective was to assess the effect of altitude on the LMA in both fixed wing and rotary wing models. We performed an in vitro study of the effect of altitude on the LMA cuff. Infant and adult airway trainer mannequins with properly sized and inserted LMA-Classic laryngeal mask airways were monitored for cuff pressure changes while flown at altitudes commonly encountered during air medical transport. Both models demonstrated that LMA cuff pressures may exceed manufacturer recommended levels for safe use even at the relatively low altitudes experienced during rotor wing flight. Properly inserted and inflated laryngeal mask airways at ground level may result in overinflated LMA cuffs when flown to altitudes commonly used for rotor and fixed wing medical transport unless monitored and corrected.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2007.04.026