Face-mask ventilation is considered a fundamental procedural skill in emergency medicine. We have historically deployed it when patients are apneic, are hypoventilating, or need assistance with oxygenation. We keep bag-mask units at the head of every bed in the emergency department.
The world of airway management has evolved since the self-inflating bag-valve mask (BVM) was first created more than 50 years ago. In elective anesthesia, the laryngeal mask airway (LMA) has entirely replaced face-mask ventilation as a strategy for airway and anesthetic management in cases with a low risk of aspiration. In fact, the laryngeal mask is now used in the majority of elective anesthesia cases worldwide. It also has a rapidly growing presence in the world of prehospital care, especially in the United Kingdom and Europe.
The tip of the laryngeal mask wedges into the upper esophagus, behind the cricoid cartilage. It provides a wedge-shaped “stopper” to the upper esophagus; it’s not quite as effective as a tracheal tube in isolating the trachea from the esophagus but is far better than pushing gas by face mask into the shared upper aero-digestive tract of the pharynx.