AANA journal
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Pulmonary aspiration during anesthesia, although rare in most patients, remains a very real concern for anesthesia providers. Recently, an extensive collection of data has emerged demonstrating a seemingly benign effect of gastric pH and volume from clear liquids consumed 2 to 3 hours prior to surgery in select patients. This AANA Journal course will evaluate the risk of pulmonary aspiration and relate this to specific identifying characteristics described to influence risk. Gastric physiology will be reviewed and current research will be examined evaluating the impact of clear liquids on specific outcome variables.
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The laryngeal mask airway (LMA) was invented by Dr. Archie Brain at the London Hospital, Whitechapel, in 1981. Dr. ⋯ The LMA is not a substitute for a properly placed endotracheal tube in this situation. The American Society of Anesthesiologists' difficult airway algorithm recommends the insertion of an LMA when ventilation and/or intubation are difficult. The distal aperture of the LMA is in close approximation to the vocal cords, so a 6.0-mm internal diameter endotracheal tube can be passed over an intubating stylet or a pediatric fiberoptic bronchoscope to secure a patient's airway.