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Intubating Laryngeal Mask Airways (ILAs)

Hi all,
Recently, there was a case where an ILA was used as a rescue device, but nobody, including anesthesia, was familiar with how to transition this device to an endotracheal tube .

Joe and I discussed this in May 2007 when we first bought these devices.

Here is a review:

The ILA  is a device specifically designed for ease of ET tube placement.

After the ILA is placed and the pt is reoxygenated, ET tube placement can be accomplished by either:

Placement of the bougie (I prefer using the straight end), and then placement of the tube over the bougie with the ILA still in place.


Placement of the intubating stylet with an ET tube over it through the ILA, which allows direct visualization of the cords through the ILA.

In both cases you need to remove but not lose the 22 mm adapter from the top of the ILA

please watch these two videos:

the videos also show how to remove the ILA after ET tube is placed and confirmed.

One key move that Rikki and I learned was to make sure the patient is paralyzed during these maneuvers or you might wind up with a face full of GI bleed blood, ummmmm GI bleed blood.

ask Joe or I if you have any questions

Scott Weingart, MD FACEP
Division of Emergency Critical Care
Department of Emergency Medicine
Mount Sinai School of Medicine

Written by reuben

July 9th, 2009 at 8:44 pm

Posted in Airway

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