VBM LT-D Manuel D'utilisation page 8

English
e) Achieve the appropriate depth of anesthesia
An adequate level of anesthesia is required before the insertion of the LT-D. Standard monitoring techniques
should be followed when inducing anesthesia. In general, the depth of anesthesia needed is little more than that
required for the insertion of a Guedel-type airway. It is recommended that the less experienced user choose a
deeper level of anesthesia.
f) Positioning the head
The ideal head position for insertion is the "sniffing position". However the shortness of the tube and the s-shape
allows it to be inserted with the head in a neutral position.
g) Insertion of the Laryngeal Tube LT-D
To position the LT-D it is necessary to use a technique which takes the anatomy into account. Follow the
instructions of use in the following sequence:
VBM 8
• The recommended technique is to hold the LT-D like a pen
in the area of the black lines (teeth marks).
• With the free hand, hold the mouth open and make sure
that the tongue is not folded back during the downward
movement of the LT-D Never use force!
• Place the flat edge of the LT-D tip against the hard palate
of the patient and slide it along the palate in the midline of
the mouth down into the hypopharynx until the center
black line is level with the upper teeth.
In case of insertion problems a lateral insertion might be
useful.
• Inflate both cuffs with the volume which is indicated on the
syringe. Due to the specially designed inflation line the
proximal cuff is filled first which stabilises the tube. Once
the proximal cuff has adjusted to the anatomy of the
patient the distal cuff will be automatically inflated.
Consider the recommended volumes:
Size 2
Size 2.5
Size 3
Size 4
Size 5
• In elective use, especially during spontaneous venti-
lation, it is recommended to advance the LT-D to the
connector. Then inflate the cuffs with the VBM Cuff
Pressure Gauge "Universal" to 60cmH O and attach the
tube to the breathing circuit. While gently bagging the
patient to assess ventilation, simultaneously withdraw the
airway until ventilation is easy and free flowing (large tidal
volume with minimal airway pressure). Re-adjust cuff
pressure and monitor continuously to avoid excessive cuff
pressures.
35 ml
45 ml
60 ml
80 ml
90 ml
2