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EMR
EMT
AEMT
Paramedic
Extended
Supraglottic Airway
Clinical Indications:
Failed intubation attempt
Unresponsive patient in need of ventilatory assistance
Bag mask ventilations are delivering insufficient volume despite clearing the airway and OPA/NPA placement
Steps
Performed?
Yes No
1.
Recognize the need for SGA placement, consider clinical indications
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2.
Preoxygenate patient as is possible
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3.
Prepare SGA device
Ensure appropriate size device based on device chart
Check cuffs for leaks, where applicable
Lubricate device as appropriate per manufacturer’s recommendations
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4.
Position the head as appropriate to perform a tongue-jaw lift. Consider c-spine
precautions.
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5.
Insert device to the appropriate depth, per manufacturer’s recommendations.
Most modern SGA devices have two to three black lines that serve as a depth indicator
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6.
Inflate the cuffs with the manufacturer recommended volume of air
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7.
Ventilate patient and confirm proper ventilation
Adequate tidal volume
Equal chest rise and fall considering other factors which would prevent this (tension pneumo,
flail chest)
Absence of epigastric sounds and presence of breath sounds
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8.
Adjust ventilation as necessary
Adjust depth of device, check cuffs, ventilate through secondary lumen, etc
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9.
Apply capnography to ensure initial and continued placement
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10. Secure the device with tape or a commercial holder
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11. Continue to ventilate the patient at the appropriate rate
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Supraglottic Airway