Purpose To provide an evidence-based overview and update on the use of the Fastrach TM Intubating Laryngeal Mask AirwayÒ (FT-LMA) when used within operative and non-operative settings. Principal findings The FT-LMA is available in three sizes to provide ventilation and the ability to pass an endotracheal tube (ETT) into the trachea blindly, semi-blindly, or with indirect visualization for patients over 30 kg. The Chandy maneuver is recommended routinely; the first maneuver optimizes ventilation, and the second maneuver increases success at endotracheal intubation (ETI). The manufacturer's reinforced tube or a pre-warmed or reversed standard ETT may be utilized. Insertion and ventilation are successful in almost all patients. Blind ETI is highly successful; adjuncts are generally not necessary. The FT-LMA has a proven role in the airway management of anticipated difficult operating room (OR) intubations, unanticipated OR intubations, cervical spine injuries, and limited airway access situations. Literature in the pre-hospital and emergency department settings is limited but favourable. The FT-LMA has compared favourably with fibreoptic intubation, the LMA-Classic TM , the laryngeal tube, and the CobraPLA TM . Initially, the more expensive LMA CTrach TM appeared to be more successful, but overall it is not. The FT-LMA airway seal pressures are excellent; serious complications are uncommon, and the FT-LMA figures prominently in most difficult airway guidelines. Conclusions The FT-LMA has proven to be a useful difficult airway device both within and outside of the operating room. Effective ventilation is established in nearly all cases, and blind ETI is possible in the vast majority of cases if the optimal techniques described are used. Serious complications are uncommon. Constatations principales Le FT-LMA est disponible en trois tailles pour permettre la ventilation et le passage d'une sonde endotrache´ale (SET) dans la trache´e de façon aveugle, semi-aveugle ou avec visualisation directe chez les patients pesant plus de 30 kg. La manoeuvre de Chandy est recommande´e de façon routinie`re; la premie`re manoeuvre optimise la ventilation, et la seconde augmente le succe`s lors d'une intubation endotrache´ale (IET). La sonde arme´e du fabricant ou une SET standard pre´chauffe´e ou inverse´e peut eˆtre utilise´e. L'insertion et la ventilation re´ussissent chez presque tous les patients. L'IET en aveugle a un taux de re´ussite e´leve´; en re`gle ge´ne´rale, les accessoires ne sont pas ne´cessaires. Le FT-LMA joue un rôle e´prouve´dans la prise en charge des voies ae´riennes lors d'intubations anticipe´es comme difficiles dans la salle d'ope´ration (SOP), d'intubations impre´vues en SOP, de le´sions de la colonne cervicale et dans les situations oul 'acce`s aux voies ae´riennes est limite´. La litte´rature portant sur son utilisation dans des contextes pre´-hospitaliers et dans le de´partement des urgences est restreinte mais favorable. Le FT-LMA a e´te´favorablement compare´al 'intubation par fibroscopie, au LMA...
