Classic Laryngeal Mask: Characteristics and Application

The classic laryngeal mask is an alternative device used to open and maintain an open airway. It was introduced into anesthetic practice in the mid-1980s and has proven to be easy to use, especially in prehospital emergency medical services.

The laryngeal mask consists of a proximal tube, similar to an endotracheal tube, which is connected to a distal elliptical cuff. When the cuff is inflated, it seals the laryngeal inlet. At the end of the tube, there is a universal 15 mm connector that attaches to a self-inflating bag or a ventilator circuit.

Ventilation using a laryngeal mask is more effective and easier than using a self-inflating bag and mask, although it does not guarantee complete airway protection and aspiration is possible, albeit very rarely.

Indications for the placement of a laryngeal mask are:

  • Unconscious patients without protective reflexes
  • Need for ventilation
  • Alternative method (when intubation is not possible)


  • Symptomatic hiatal hernia
  • Pathological obesity
  • Pregnancy beyond 14 weeks
  • Multiple and severe facial injuries (oropharyngeal)
  • Acute abdomen
  • Chest injuries
  • Conditions associated with delayed gastric emptying
  • Chronic obstructive pulmonary disease
  • Use of a laryngeal mask in patients with a full stomach


Procedure for Placing a Classic Laryngeal Mask:

  1. Apply protective equipment (gloves, goggles, face mask).
  2. Select the appropriate size of the laryngeal mask (sizes 3, 4, and 5 for adults).
  3. Check the mask for any physical and mechanical damage.
  4. Check the integrity of the cuff by inflating it with the maximum amount of air.
  5. Fully deflate the cuff.
  6. Apply a lubricant to the back side of the cuff.
  7. Position yourself above the patient’s head.
  8. Pre-oxygenate the patient with 100% oxygen for 2 minutes.
  9. Position the patient’s head in a similar position to that for intubation (maintain a neutral head and neck position if a spinal injury is suspected).
  10. Hold the mask with the dominant hand like a pencil, with the index finger at the junction of the tube and the cuff.
  11. Insert the mask into the oral cavity with the opening facing forward, sliding the back along the palate.
  12. Move the tip past the upper incisors with the top surface against the palate until resistance is felt when the tip of the mask touches the esophageal sphincter.
  13. Ensure the tip of the mask does not fold over.
  14. Remove the finger used to insert the mask from the oral cavity and hold the mask close to the mouth with the other hand.
  15. Inflate the cuff with the appropriate amount of air (size 3 with 20 ml of air, size 4 with 30 ml, size 5 with 40 ml).
  16. During inflation, the mask will seat itself into the correct position.
  17. Verify the effectiveness of placement and ventilation by auscultation and observing chest movement.
  18. Placement time is 30 seconds; if unsuccessful, remove, re-oxygenate, and repeat the procedure.


  • Simplicity of the procedure
  • Better ventilation compared to mask ventilation with a self-inflating bag



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