Equipment 8-522 - Laryngeal Mask Airway (LMA)

CMH EMS & MIH Protocols

Scope of Practice:

Advanced Emergency Medical Technician

Registered Nurse

Paramedic

Indications:

Contraindications:

Swallow or gag reflex.

Precautions:

None.

Procedure:

Examine LMA for damage, leaks, and blockages.

Inflate cuff with 150% that listed. Fully deflate by compressing the distal tip of the mask with thumb and index finger. Apply slight tension to the inflation line while removing all air until a vacuum is felt. Disconnect the syringe.

Generously lubricate posterior surface of cuff and airway tube.

Place the patient’s head in a neutral or slight "sniffing" position. Hold the LMA at the proximal end with the connector pointing downward to the chest and the tip of the distal end pointing toward the palate.

Press the tip of the mask against the hard palate. Maintaining pressure against the palate, continue to rotate the mask inwards in a circular motion following the curvature of the hard and soft palate.

Continue until resistance is felt. The distal end of the mask should now be in contact with the upper esophageal sphincter. The device is now fully inserted.

Maintaining inward pressure, secure the mask into position by taping cheek to cheek across the fixation tab. This should be done prior to inflation. Inflate with the minimum amount of air needed to achieve an effective seal.

Advanced Life Support:

Continued sedation:

Consider Versed 2.5-5 mg every 5 min. Repeat as needed maintaining SBP greater than 100.
Consider Fentanyl 50-100 mcg. Max 300 mcg.

MANDATORY AFTER INSERTION TO CONFIRM PLACEMENT:

Place Gastric Tube into the drain tube of the LMA and advance into the stomach. The gastric tube should be well lubricated and passed slowly and carefully. Suction should not be performed until the gastric tube has reached the stomach.

Sizing Table:

Mask size	Patient size	Max cuff inflation volume	Largest gastric tube size
1	Neonates/infants up to 5 kg	5 ml	6 Fr
1.5	Infants 5 - 10 kg	8 ml	6 Fr
2	Infants 10 - 20 kg	12 ml	10 Fr
2.5	Children 20 - 30 kg	20 ml	10 Fr
3	Children 30 - 50 kg	30 ml	14 Fr
4	Adults 50 - 70 kg	45 ml	14 Fr
5	Adults 70 - 100 kg	45 ml	14 Fr

Mask size

Patient size

Max cuff inflation volume

Largest gastric tube size

Neonates/infants up to 5 kg

5 ml

6 Fr

1.5

Infants 5 - 10 kg

8 ml

6 Fr

Infants 10 - 20 kg

12 ml

10 Fr

2.5

Children 20 - 30 kg

20 ml

10 Fr

Children 30 - 50 kg

30 ml

14 Fr

Adults 50 - 70 kg

45 ml

14 Fr

Adults 70 - 100 kg

45 ml

14 Fr

Change Log:

Date	Link to previous version	Description of change
12/15/13	pdf	Added EMT scope of practice statement.
05/05/15	pdf	Updated this protocol from basic LMA to LMA supreme with specific procedure from manufacturer and included mandatory statement for gastric tube similar to King airway.
06/01/15		Added indications in Protocol 6-025 - Cardiopulmonary Resuscitation (CPR), Protocol 6-110 - Rapid/Delayed Sequence Intubation (RSI), and Section 8-080 - Endotracheal Tube (ET).
07/04/20		Renumbered the section to allow for future additions.
08/07/20	pdf	Added content (without substantive modification) from old Section 8-170 - Laryngeal Mask Airway (LMA).
06/15/21	pdf	Moved to emsprotocols.online
12/01/21		Updated link to Versed.
03/20/23		Changed link for Fent.

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Equipment 8-522 - Laryngeal Mask Airway (LMA)

Scope of Practice:

Indications:

Contraindications:

Precautions:

Procedure:

Sizing Table:

Citations:

Change Log: