This area summarizes the most important insertion information for LMA™ airways. Please refer to the current LMA™ Instruction Manuals for LMA™ airway-specific information including important warnings and cautions.

• Introducer
• Index finger
• Thumb

Deflate the cuff of the mask and apply a water-soluble lubricant to the posterior surface. Hold the LMA ProSeal™ like a pen in the dominant hand, with the index finger placed at the junction of the cuff and the two tubes, so that the fingertip is pushed into the Introducer strap (Fig. 1 and Fig. 2).

Note position of wrist through entire procedure (Fig. 2 - 6).
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Press the tip of the cuff upward against the hard palate and flatten the cuff against it (Fig. 3).

Using the index finger to guide the LMA ProSeal™, press backward toward the other hand (Fig. 4 and Fig. 5), which exerts counter-pressure (do not use force).

Advance the LMA ProSeal™ into the hypopharynx until a definite resistance is felt (Fig. 6). Hold the outer end of the airway tube while removing the index finger (Fig. 7). Inflate the cuff (as in Introducer technique).

Thumb Technique:

Deflate the cuff of the mask and apply a water-soluble lubricant to the posterior surface. Hold the LMA ProSeal™ with the thumb in the strap (Fig. 1).

Insertion is similar to that using the index finger (Fig. 2); however, the thumb should be used to extend the head just prior to completing insertion (Fig. 3). Fingers should be extended over head allowing the thumb to pass further inward (Fig. 4).

Hold the outer end of the airway tube while removing the thumb (Fig. 5).

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Deflate the cuff of the mask and apply a water-soluble lubricant to the posterior surface. Rub the lubricant over the anterior hard palate (Fig. 1). Ensure the curved metal tube is in contact with the chin and the mask tip flat against the palate prior to rotation (Fig. 2).

Swing mask into place with a circular motion, maintaining pressure against the palate and posterior pharynx
(Fig. 3).

Intubating through the LMA Fastrach™

Visually inspect and inflate ETT to verify cuff integrity and symmetry. Deflate cuff, lubricate ETT and pass through LMA Fastrach™ tube (rotate with up/down movement) to distribute lubricant. Pass the ETT to 15 cm depth marker or the transverse line on the LMA Fastrach™ ETT which corresponds to passage of tube tip through the epiglottic elevating bar (Fig. 1). Use the handle to gently lift the device 2 - 5 cm as the ETT is advanced (Fig. 2). Carefully advance until intubation is complete. Do not use force. Inflate ETT cuff and confirm intubation.

Removal of LMA Fastrach™ over ETT

Remove connector and gently ease the LMA Fastrach™ out over the ETT into the oral cavity. Use stabilizer rod to "hold" ETT in position as LMA Fastrach™ is withdrawn over tube (Fig. 3).

Remove the stabilizer rod and hold onto the ETT at the level of the incisors(Fig. 4).

Remove the LMA Fastrach™ completely, gently unthreading the inflation line and pilot balloon of the ETT (Fig. 5). Replace the ETT connector (Fig. 6).

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Tightly deflate the cuff so that it forms a smooth "spoon-shape" (Fig. 1). Lubricate the posterior surface of the mask with water-soluble lubricant.

Hold the LMA™ airway like a pen, with the index finger placed at the junction of the cuff and the tube (Fig. 2)

With the head extended and the neck flexed, carefully flatten the LMA™ airway tip against the hard palate (Fig. 3).

Use the index finger to push cranially, maintaining pressure on the tube with the finger. Note position of the wrist. Advance the mask until definite resistance is felt at the base of the hypopharynx (Fig. 4).

Gently maintain cranial pressure with the non-dominant hand while removing the index finger (Fig. 5).

Without holding the tube, inflate the cuff with just enough air to obtain a seal (to a pressure of approximately 60 cm H2O)(Fig. 6). Never overinflate the cuff.