VBM LT-D Manuel D'utilisation page 9

Potential problems with inserting the LT-D
Jaw thrust or chin lift may help to advance the LT-D because it lifts the base of the tongue.
If no sufficient ventilation can be verified, re-position the LT-D between the teeth marks.
It is recommended to insert the LT-D initially deeper. While gently bagging, slowly withdraw the tube with inflated
cuffs until ventilation is easy and free flowing (large tidal volume with minimal airway pressure). Withdrawal of the
LT-D with inflated cuffs results in a retraction of tissue away from the laryngeal inlet and it prevents the epiglottis
or other tissue to be drawn into the ventilation holes of the tube during spontaneous ventilation.
If airway problems persist or ventilation is still inadequate, the LT-D should be removed and an airway
established by other means.
An inadequate depth of anesthesia may result in coughing and breath holding during LT-D insertion. Should this
occur, the anesthesia should be deepened immediately and manual ventilation resumed.
To avoid trauma, force should not be used at any time during insertion.
h) Removal of the LT-D
Once it is in the correct position, the LT-D is well tolerated until the return of protective reflexes. Intra-cuff
pressures should be maintained around 60cmH O.
Note: For LT-D removal, it is important that both cuffs are completely deflated with the included syringe to
avoid cuff damage.
Removal should always be carried out in an area where suction equipment and the ability for rapid
intubation are present.
• The LT-D should now be properly positioned and the patient
can be ventilated.
Check lung ventilation by auscultation, capnography and
chest movement. If ventilation is not sufficient, re-position the
tube between the teeth marks.
If efficient ventilation is achieved, the LT-D can be fixed in
position. The biteblock can do this, but is not required.
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English
VBM 9