ANESTHESIA QUICK REVISION NOTES

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INSTRUMENTS IN ANESTHESIA : LMA (Laryngeal mask airway ) / SAD (Supraglottic airway device ) Scientist who invented it - Archie Brain Types of LMAs : ( Active recall – try to identify and recal... l important points about each of these ) First generation LMA •• Example – LMA classicQ •• Important features - single tube present (airway tube ), which can be used for ventilation only - Demerit : cannot prevent aspiration Second generation LMA •• Examples - LMA supreme, Proseal LMA, I gel LMA, Fast trach LMA or Intubating LMA •• Important features - They have airway tube and gastric tube •• They create a better seal with the larynx than first generation LMAs •• They are safer and protects better against aspiration 84 Cerebellum Quick Revision Notes LMA CLASSIC •• First generation LMA •• Important features - single tube present (airway tube ) •• Demerit : cannot prevent aspiration LMA supreme •• Second generation LMAQ •• Disposable Fast track LMA or Intubating LMA •• Made up of Silicone •• Non disposable •• Can be used upto 40 times •• Pilot Balloon is present •• It has a special endotracheal tube used for intubating ‘through’ the LMA •• It is sterilized by Autoclaving PROSEAL LMA •• It is made up of Silicone •• It is reusable / non disposable •• Pilot balloon is present •• It forms a good seal with the larynx preventing aspiration of gastric contents. Hence, it is called as ‘Proseal’ It is the LMA preferred for Day care Surgery / Laproscopic Surgery I - gel LMA •• Main identification feature – It does not have a pilot balloon •• It is made up of Thermoelastic polymer Recommended size of the laryngeal mask airway according to the patient's body weightQ. Size Patient's weight 1 <5 kg 1.5 5-9 kg 2 10-19 kg 2.5 20-29 kg 3 30-49 kg 4 50-69 kg 5 Large adult, 70-100 kg Ideal patient position preferred for intubation : Sniffing the morning air position / barking dog position Q 85 Anesthesia Extension of atlanto occipital joint Flexion of cervical spine Flexion at Atlantoaxial joint and extension at Atlantooccipital joint Steps of Intubation 1. Insert the Laryngoscope in the right corner of the mouth 2. Sweep the tongue from right to leftQ 3. Then lift the laryngoscope 4. Once the vocal cords are seen pass the endotracheal tube 5. Inflate the cuff of the endotracheal tube and connect the anesthesia circuit 6. Confirm intubation by capnography (gold standard) or by auscultation or chest XrayQ Identification of types of laryngoscope: (Active recall) MacIntosh laryngoscope •• It has a Curved blade •• It is used in Adults McCoy laryngoscopeQ •• It has a curved blade with a lever which helps in lifting the epiglottis •• It is used for difficult intubation Millers laryngoscope •• It has a straight blade •• It is used in pediatric patients [Show More]

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