Awake iLMA® intubation

Dr Chandy Verghese demonstrates the awake insertion of an iLMA® (intubating laryngeal mask airway) in himself after local anaesthetic spray and injection.

The iLMA® is known as the LMA-Fastrach™ outside of the United Kingdom.

Category:

Science & Technology

Tags:

• Anaesthesia
• LMA
• Anesthesiology
• Airway
• Anesthesia
• Awake
• intubation
• Selbstintubation
• Laryngeal
• Mask

[mariesadler]

Do people ever use this without numbing the throat. For example anaphylactic shock patients?

[plaloe]

@mariesadler - Airways like the intubating LMA can be inserted with people either Awake (1) OR Asleep (2).

(1) For inserting in Awake patients (like in this video) the airway should be numbed AND / OR sedative medicines need to be given. This will depend on the patient's pattern of breathing, the indication for the use of an Awake technique, and the technique of the attending anesthesiologist.

[plaloe]

@mariesadler

(2) For Asleep patients, whether it be a planned general anaesthesia OR an unconscious patient (like in cases of severe head injury, cardiac arrest or severe shock) the throat does not need to be numbed because the whole patient is Asleep.

Why do you ask about anaphylaxis specifically?

[melbrent]

I'm wondering whether this procedure is slightly traumatising for patients? Any experience using this with the lay person? I'd be interested to hear feedback.

[plaloe]

@melbrent - Thanks for your questions. With proper patient preparation, suitable anxiolytic medication & a considerate approach, these sorts of necessary medical treatments can be carried out safely with relaxed patients. In particular with the judicious use of medication, many patients don't recall the event. Besides, because the local anaesthetic makes it completely painfree (like in this video), it is well tolerated.

[rxfudd]

Holy crap.

My hat is off. You, sir, have gargantuan testicles.

[hopelessxl]

Hey folks..........this is the guy who actually invented this particular form of the device...............those familiar with iLMA insertion techniques must have heard about Chandi maneuvre. And the person who takes a look at the bronchoscope later is Dr. Archie Brain himself........the father of laryngeal mask airway. The gods are all together in this one.

[dratuldixit]

Great video!!! Thanks doctor!

[Shellerjc]

Interesting - Thank you for placing this on the internet -

[Shellerjc]

Do u even know what the LMA fastrach can do for you in an emergency?