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Updated: Aug 22, 2025

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The Laryngeal Mask: Empowering Nurses to Rescue Newborns.

Jeanette Zaichkin, Linda D McCarney, Michelle Rhein

    Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
    |November 10, 2022
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    Summary

    The laryngeal mask (LM) is an effective rescue airway for newborns when ventilation fails and intubation is not possible. Training nurses on LM use can improve neonatal resuscitation outcomes.

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    Area of Science:

    • Neonatal Resuscitation
    • Pediatric Airway Management

    Background:

    • The Neonatal Resuscitation Program (NRP) has recommended the laryngeal mask (LM) as an alternative airway since 2005.
    • Limited literature exists on LM use in high-resource settings, with anecdotal evidence suggesting low implementation.

    Purpose of the Study:

    • To enhance awareness of the safety and efficacy of laryngeal mask use in neonatal resuscitation.
    • To provide guidance on determining nursing scope of practice for LM insertion.
    • To offer suggestions for developing effective LM training programs for healthcare professionals.

    Main Methods:

    • Review of Neonatal Resuscitation Program (NRP) customer inquiries.
    • Analysis of recent systematic reviews on laryngeal mask efficacy.
    • Examination of NRP recommendation development processes.
    • Assessment of nursing scope of practice determination for airway devices.
    • Consideration of best practices for developing simulation-based training programs.

    Main Results:

    • Recent studies support the NRP recommendation for using the LM as a rescue airway when positive-pressure ventilation (PPV) fails and intubation is not feasible.
    • Laryngeal mask ventilation demonstrates greater effectiveness compared to traditional face-mask ventilation.
    • The LM may be suitable as an initial PPV device for infants with a gestational age of at least 34 weeks.
    • Nurses may require specific training, potentially including simulation-based curricula, for effective LM utilization.

    Conclusions:

    • Nurses can be trained to improve their understanding of laryngeal mask advantages, define their scope of practice, and implement training programs.
    • Laryngeal mask insertion is likely to improve heart rate and prevent the need for intubation in newborns when initial ventilation methods are unsuccessful and intubation is not feasible.
    • Future research should focus on training requirements, the LM's efficacy as an initial PPV device in high-resource settings, and its application in complex neonatal resuscitations and preterm infants.