The laryngeal mask airway (LMA) is accepted as both a rescue ventilation and a primary airway management device in both the prehospital and emergency department environments.^1–3 A modified version of the LMA, the intubating laryngeal mask airway (ILMA, LMA-Fastrach; Intavent Ltd, Reading, UK) exists, which, when combined with a modified tracheal tube, can be used for blind tracheal intubation. There is evidence that the ILMA is an effective means of maintaining ventilation and oxygenation in the prehospital,⁴ operating theatre,⁵ and emergency department^6,7 environments. In addition, it has been reported to be effective in facial trauma,⁷ neck immobilisation,^8,9 in a lateral position,¹⁰ while wearing a chemical protective hood,¹¹ and while in a helicopter.¹² Importantly, it has been shown to be effective even among inexperienced operators.^6,8,13,14 A best evidence equipment review was undertaken to assess whether, when compared with a conventional LMA, the ILMA would be of use as an airway rescue device.

DESCRIPTION OF DEVICE

The ILMA is a modified version of the LMA, which, in addition to permitting ventilation, is designed to facilitate blind tracheal intubation with a tracheal tube in an obtunded or anaesthetised patient. It has a soft inflatable laryngeal mask and a rigid, anatomically curved airway tube terminating in a standard 15 mm connector and is wide enough to accept a cuffed 8 mm tracheal tube. The rigid handle permits removal and “steering” of the device in relation …