Pharmacologically assisted laryngeal mask insertion: a consensus statement

PALM: what is it?The PALM technique has been described in polytrauma patients with a reduced Glasgow Coma Scale (GCS) and ongoing airway obstruction as well as airway soiling from facial injuries. The patients have often been trapped. With basic airway manoeuvres and adjuncts failing to maintain oxygenation, the patient's level of consciousness is reduced further pharmacologically, without the use of neuromuscular blockade. This allows insertion, and ongoing tolerance, of a SAD with the option of assisting ventilation if this is required.

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