Fichas
LMA
Fichas del conjunto (13)
- 1Cuff Volume forumla• (LMA Size x10)–10
• This formula will work for sizes 2, 3, 4, 5, 6 • Example (Size 4x10)=40
40 – 10 = 30ml of air in the cuff - 2Read weight ranges• According to St John
– Under 1 year old
• 5kg
– 1-10 years old
• (Age in years +4) x2
– 11-14 years old •
Age in years x3 - 3Indications• GCS 3/15
• BMV is difficult
• Airway is poor despite OP/NP airway & jaw thrust
• Pt. needs intubation, but no one to do it
• Intubation has failed
• To facilitate intubation - 4LMA Prep• Equipment needed – LMA
• All air expelled from cuff and cuff checked – Syringe
– Water based lubricant
• Applied to posterior tip of the LMA
– BVMR + O2
– Securing device
– Alternative airway adjunct - 5Patient Positioning (Useful for difficult airways)The sniffing position brings the external auditory canal slightly anterior to the shoulder
- 6Paediatric Airway PositioningExternal auditory canal is just anterior to the shoulder
- 7Insertion Technique• Pre-oxygenate the patient
• Position head correctly
• Insert LMA until definitive resistance is felt (Don’t force it in)
• Inflate Cuff
• Attach Cobbs connector
• Test for seal and chest rise
• Secure - 8Bite blocks• Should not interfere with the LMA’s cuff.
• OPA’s are not considered the best first choice of bite block for LMA’s
• OPA’s can be used as bite blocks for Endotracheal tubes.
• Use a purpose built bite block (Thomas tube holder) or gauze - 9Cobbs connectors / Catheter Mounts• Adds approx. 30ml of dead space to the airway
- 10Trouble Shooting DOPES• Dislodged
• Obstruction
• Pneumothorax
• Equipment failure
• Stomach Distension - 11Regurgitation• Leave LMA in place.
• Do not ventilate if fluid is found in the tube.
• Disconnect BVM and suction before re-ventilating - 12LMA’s during CPR• Ratios do not change.(Unlike St John guidelines)
• Compressions and ventilations are still performed in a synchronous fashion
• Compression pressure will cause cuff seal failure if done during ventilation attempts - 13Removal of the LMA• Do NOT deflate the cuff.
• Suction any secretions around the cuff
• Remove when patient breaths out
• Be aware that they may flick fluids on removal
Información
- Descripción
- 6 CP1 Fichas sobre LMA, creado por Jonathan Cash el 19/07/2016.
- Creado por
- Jonathan Cash
- Visitas
- 3
- Etiquetas
- Valoración