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Am J Perinatol 2023; 40(14): 1551-1557
DOI: 10.1055/s-0041-1736662
Original Article

Laryngeal Mask Use in the Neonatal Population: A Survey of Practice Providers at a Regional Tertiary Care Center in the United States

Birju A. Shah 
1   Neonatal-Perinatal Medicine, Oklahoma Children's Hospital, OU Health, Oklahoma City, Oklahoma
2   Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Arlen Foulks
1   Neonatal-Perinatal Medicine, Oklahoma Children's Hospital, OU Health, Oklahoma City, Oklahoma
2   Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Maria C. Lapadula
2   Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Mike McCoy
1   Neonatal-Perinatal Medicine, Oklahoma Children's Hospital, OU Health, Oklahoma City, Oklahoma
,
Gene Hallford
2   Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Susan Bedwell
1   Neonatal-Perinatal Medicine, Oklahoma Children's Hospital, OU Health, Oklahoma City, Oklahoma
3   Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Lise DeShea
2   Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Edgardo Szyld
1   Neonatal-Perinatal Medicine, Oklahoma Children's Hospital, OU Health, Oklahoma City, Oklahoma
2   Pediatrics, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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Abstract

Objective The aim of this study was to evaluate the level of training, awareness, experience, and confidence of neonatal practice providers in the use of laryngeal mask (LM), and to identify the barriers in its implementation in the neonatal population.

Study Design Descriptive observational study utilizing an anonymous online questionnaire among healthcare providers at the Oklahoma Children's Hospital who routinely respond to newborn deliveries and have been trained in the Neonatal Resuscitation Program (NRP). Participants included physicians, trainees, nurse practitioners, nurses, and respiratory therapists.

Results Ninety-five participants completed the survey (27.5% response rate). The sample consisted of 77 NRP providers (81%), 11 instructors (12%), and 7 instructor mentors (7%). Among 72 respondents who had undergone LM training, 51 (54%) had hands-on manikin practice, 4 (4%) watched the American Academy of Pediatrics (AAP) NRP educational video, and 17 (18%) did both. Nurses (39 out of 46) were more likely to have completed LM training than were physicians (31 out of 47). With only 11 (12%) participants having ever placed a LM in a newly born infant, the median confidence for LM placement during neonatal resuscitation was 37 on a 0 to 100 scale. Frequently reported barriers for LM use in neonates were limited experience (81%), insufficient training (59%), preference for endotracheal tube (57%), and lack of awareness (56%).

Conclusion While the majority of the neonatal practice providers were trained in LM placement, only a few had ever placed one in a live newborn, with a low degree of confidence overall. Future practice improvement should incorporate ongoing interdisciplinary LM education, availability of LM in the labor and delivery units, and promotion of awareness of LM as an alternative airway.

Key Points

  • LM is underutilized as an alternative airway.

  • Insufficient experience and training limit LM use.

  • Providers confidence with LM placement is low.

Keywords

supraglottic airways - laryngeal mask - newborn resuscitation - barriers to LM use - lack of laryngeal mask awareness - alternative airway - NRP


Publication History

Received: 20 January 2021

Accepted: 28 September 2021

Article published online:
02 November 2021

© 2021. Thieme. All rights reserved.

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