AB220. 113. An audit of adult laryngeal mask airway size selection

Background: Laryngeal mask airway (LMA) size selection is a clinical decision anaesthetist making on a daily basis. Selection is often made on both a gender and past behavioural basis. Actual patient bodyweight is the determining physical characteristic advised by the device manufacturer as a sizing guideline. This guideline is clearly displayed as a weight range, in kilograms, on the side of each LMA device. We sought to audit the compliance of anaesthetists with manufacturer’s guidelines.

Methods: Over a 6-week period in University Hospital Limerick (UHL) the size of each LMA placed during anaesthesia was recorded. Multiple physical characteristics for each patient were also recorded. An educational intervention of best practice sizing of LMAs was then carried out prior to a follow-on re-audit of practice.

Results: In total, 110 LMA devices placements were recorded during the audit period. Sixty-nine (63%) were used outside recommended guidelines. The follow-up audit did not yield a change in practice with 70% of LMAs considered an incorrect size; however, in each case it was undersized rather than oversized.

Conclusions: This audit revealed that the majority of LMA devices provided to adult, surgical patients at University Hospital Limerick in June 2017 were undersized with respect to the device manufacturer guidelines. An audit intervention in the form of a department reminder did not increase adherence to sizing guidelines.

Keywords: Laryngeal; mask; airway; size; audit