• Daniel H Lee, Glenn Paetow, Matthew E Prekker, and Brian E Driver.
• Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
• J Emerg Med. 2022 Jul 1; 63 (1): 889288-92.

BackgroundThe LMA Fastrach (LMA North America, Inc; hereafter termed the intubating laryngeal mask airway [ILMA]) is an extraglottic device designed to facilitate endotracheal intubation. After the endotracheal tube is placed through the lumen of the ILMA into the trachea, the ILMA is removed, using a proprietary stabilizer rod to hold the tube in place.DiscussionThe traditional method of ILMA removal is not optimized for the critically ill patient. It requires the use of unfamiliar equipment, exposes the patient to a significant period without ventilation, and risks tube dislodgement. We designed a simple technique with a double-endotracheal tube setup that addresses these problems using common equipment, allowing for continuous ventilation, and minimizing the risk of tube dislodgement.ConclusionsThe traditional method of ILMA removal around an endotracheal tube is not designed for critically ill patients or the physicians taking care of them. This novel technique is designed to improve the usability of the ILMA for physicians and improve airway outcomes for patients.Copyright © 2022. Published by Elsevier Inc.

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