OUR NASAL LARYNGEAL MASK AIRWAY IS PRESENTED AS A PACK CONTAINING:
Flexible reinforced laryngeal mask airway with a removable 15 mm ISO connector.
Flexible reinforced airway tubing having a fixed 15 mm ISO connector and a connector to mate to an Introducer.
ORAL TO NASAL LARYNGEAL MASK
A flexible reinforced oral laryngeal mask is used to secure the airway. Anaesthesia is maintained and the patient ventilated.
The distal end of the flexible reinforced airway tubing having the same diameters of the airway tubing of the laryngeal mask with a standard 15mm connector at the proximal end is connected with a smooth, tapered, curved and blunt ended introducer is passed through the most patent nostril. The Introducer and is grasped and delivered through the mouth with Magill’s forceps and once approximately 5cm of the airway tubing protrudes from the lips the introducer is removed.
The anaesthetic circuit is now removed from the oral laryngeal mask and connected to the proximal end of the nasal airway tubing. The 15mm connecter is removed from the oral laryngeal mask airway tubing and joined to the distal end of the airway tubing protruding through the mouth. This allows for continued patient ventilation and maintained anaesthesia.
The airway tubing of the laryngeal mask is stabilized in the oro-pharynx and the redundant airway tubing of the joined laryngeal mask and nasal airway tubing is reduced by gentle traction on the nasal airway tubing distal to the nares.
Once satisfied that the laryngeal mask is in the correct position and ventilation is maintained the nasal airway tubing is disconnected from the laryngeal mask tubing and the 15mm connector is reinserted in the laryngeal mask airway tubing and reconnected to the airway circuit. The original oral laryngeal mask is now reconfigured as a nasal laryngeal mask.
The pilot balloon and tubing may be stored in the mouth if necessary.
NASAL TO ORAL LARYNGEAL MASK
The anaesthetic circuit is removed from the nasal laryngeal mask and the 15mm connector is removed from the distal end. The anaesthetic circuit is connected to the proximal nasal airway tubing and the distal end of this tube is connected to the laryngeal mask tubing allowing continued ventilation and anaesthesia.
The proximal end of the laryngeal mask airway tubing connected to the body of the laryngeal mask is stabilized in the oro-pharynx while the airway tubing distal to the nares is gently pushed back through the naso-pharynx and the redundant tubing is delivered through the mouth. When the connection between the laryngeal mask and nasal tubing is visualised it is disconnected and the 15mm connector reinserted into laryngeal mask tubing and connected to the anaesthetic circuit. The Nasal laryngeal mask is now reconfigured as the original oral laryngeal mask.