Supraglottic Airways Laryngeal mask airways (LMAs) are the most common supraglottic airways (SGAs) used as rescue devices for adults and children ( e-Fig 8.2 ) They consist of a teardrop-shaped cuff which can be inflatable or self-inflating that surrounds an aperture at the end of a tube When properly inserted, the cuff sits in the hypopharynx above and behind the glottis opening Airflow through the device is directed anteriorly through the glottis into the lungs SGAs are manufactured in a range of sizes that are suitable for patients throughout the pediatric age spectrum, including newborns and infants Multiple models are available Some SGAs allow the passage of an ETT through the aperture into the trachea Second-generation SGAs have integrated channels that allow gastric access for decompression of air following bag mask ventilation, or gastric contents in unfasted patients Numerical sizing conventions of SGAs are nonuniform among manufacturers, however most devices have information on either their packaging or the device itself displaying the correct patient size and volume of air for cuff inflation a given device requires Studies in anesthesia, emergency medicine, and pediatrics have shown that SGAs are easy to place, require very little training to use effectively, and have a very low complication rate Clinical data on SGA use on adults with cardiac arrest in the prehospital arena and depressed newborns in the delivery suite have demonstrated comparable effectiveness and equivalent or improved clinical outcomes when compared with prehospital TI and BVM ventilation, respectively Other Supraglottic Devices The following list describes several additional available options for rescue devices during emergency airway management All of these devices have in common that there are limited clinical data outside the operating room demonstrating ease of use or relative efficacy in pediatric patients Esophageal Combination Tube (Combitube) The Combitube is a dual-lumen tube with two inflatable cuffs: a larger proximal one and a smaller distal one When blindly inserted, the device usually enters the esophagus (>95% of attempts), but is designed in such a way that ventilation can be accomplished with either esophageal or tracheal placement, depending on which port is attached to the bag-valve device Combitubes only exist in sizes small enough to accommodate a patient 1.2 m in height; thus, the pediatric application of Combitubes is limited to older children Laryngeal Tube