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Am J Perinatol 2024; 41(11): 1476-1483
DOI: 10.1055/s-0043-1771017
Original Article

Laryngeal Mask Airway Clinical Use and Training: A Survey of North American Neonatal Health Care Professionals

Beverley Robin   *
1   Division of Neonatology, Department of Pediatrics, Rush University Medical Center; Chicago, Illinois
,
Lamia M. Soghier   *
2   Department of Neonatology, Children's National Hospital, The George Washington University School of Medicine and Health Sciences; Washington, District of Columbia
,
Akshaya Vachharajani 
3   Department of Child Health, University of Missouri, Columbia, Missouri
,
Ahmed Moussa
4   Department of Pediatrics, CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
5   CHU Sainte-Justine Research Center, University of Montreal, Montreal, Quebec, Canada
› Author Affiliations Funding None.
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Abstract

Objective The aim of this study was to explore North American neonatal health care professionals' (HCPs) experience, confidence, skill, and training with the laryngeal mask airway (LMA).

Study Design This was a cross-sectional survey.

Results The survey was completed by 2,159 HCPs from Canada and the United States. Seventy nine percent had no clinical experience with the LMA, and less than 20% considered the LMA an alternative to endotracheal intubation (EI). The majority had received LMA training; however, 28% of registered nurses, 18% of respiratory therapists, 17% of physicians, and 12% of midwives had never inserted an LMA in a mannequin. Less than a quarter of respondents agreed that the current biennial Neonatal Resuscitation Program instruction paradigm is sufficient for LMA training. All groups reported low confidence and skill with LMA insertion, and compared with all other groups, the respiratory therapists had the highest reported confidence and skill.

Conclusion This survey study, which is the first of its kind to include midwives, demonstrates that neonatal HCPs lack experience, confidence, skill, and training with the LMA, rarely use the device, and in general, do not consider the LMA as an alternative to EI. These findings contribute to, and support the findings of previous smaller studies, and in conjunction with the diminishing opportunities for EI, highlight the need for programs to emphasize the importance of the LMA for neonatal airway management and prioritize regular LMA training, with focus that parallels the importance placed on the skills of EI and mask ventilation.

Key Points

  • Lack of training for laryngeal mask airway use in neonatal resuscitation.

  • Neonatal health care professionals rarely use the laryngeal mask airway as an alternate airway device.

  • Neonatal health care professionals lack confidence and skill with the laryngeal mask airway.

Keywords

LMA - survey - North American - neonatal health care professionals - neonatal resuscitation

Authors' Contributions

L.M.S., B.R., and A.M. conceptualized this work, drafted the survey and the initial manuscript. A.M. conducted the statistical analysis. All authors reviewed and revised the manuscript. All authors approve the final manuscript as submitted and agree to be accountable for all aspects of the work.


* These authors contributed equally to this work.




Publication History

Received: 25 January 2023

Accepted: 02 June 2023

Article published online:
10 July 2023

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