*7.3.4.2 Size selection, practical aspect, adjuncts*

It is commercially available in size 3, 4 and 5. The manufacturer recommends using a size 4 device for normal adults. After insertion, the device is fixed in place and inflated to the recommended pressure. There should be a minimum of a 1 cm gap between the fixation tab and the patient's upper lip. The cuff should be inflated with sufficient air to prevent a leak with positive pressure ventilation, but it must not exceed either a pressure of 60 cm H2O or the specific device cuff volume maxima. If no manometer is available, inflate with just enough air to achieve a seal sufficient to permit ventilation without leaks. It provides high first attempt and overall insertion success rate. It helps rapidly achieve effective ventilation with reliable airway seal. Additionally, it acts as a conduit for FOB guided intubation [75, 76].
