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7. Insertion
7.1. Pre-insertion preparation
Before insertion Ambu recommends to defl ate the cuff completely so that the cuff is fl at and free of wrinkles.
Simply press the cuff down onto a fl at sterile surface (e.g. a piece of sterile gauze) while at the same time defl ating
the device with a syringe. Complete defl ation results in a shape similar to the rim of a saucer, and facilitates insertion
and correct positioning of the device.
Studies show that insertion of the laryngeal mask airway with the cuff either defl ated or partly infl ated is equally
successful in experienced hands. Therefore the clinician can insert the Ambu AuraOnce with a defl ated or partly
infl ated cuff, since both ways works succesfully.
See fi gure
e
. Defl ation of Ambu AuraOnce.
WARNING
Lubricate only the posterior tip of the cuff to prevent blockage of the airway aperture or aspiration of
the lubricant.
To further facilitate insertion into the patient, a sterile, water-based lubricant (e.g. K-Y Jelly®) should be applied
to the distal posterior surface of the cuff (local anaesthesia is not recommended).
7.2. Insertion
Before insertion, it is essential that all clinicians using the Ambu AuraOnce are familiar with the warnings, precautions,
indications, and contraindications found in these Product Information.
The following points are extremely important:
• Check for correct defl ation and lubrication as described above.
• The size of the Ambu AuraOnce must fi t the patient. Use the guidelines in Table 3 combined with clinical judgement
to select the correct size.
• Always have a spare Ambu AuraOnce ready for use.
• Pre-oxygenate and use standard monitoring procedures.
• Check that the level of anaesthesia (or unconsciousness) is adequate before attempting insertion.
• The head of the patient should be position extended with fl exion of the neck in a position normally used for
tracheal intubation (i.e. “the sniffi ng position”).
• Never use excessive force.
7.3. Insertion Techniques
There are many insertion techniques currently in use. Insert the Ambu AuraOnce in accordance with currently accepted
medical techniques. One commonly used technique is the Pencil Insertion Technique, which is described below.
When inserting the Ambu AuraOnce correctly, you must be careful about the following: Ensure that the cuff tip
avoids entering the valleculae or the glottic opening and does not become caught up against the epiglottis or the
arytenoids. The cuff should be defl ated and pressed against the patient’s posterior pharyngeal wall.
When the mask is in place, resistance will be felt.
