This is little more than an eduated guess, but it seems that LA here could be the title of the person writing the notes, this job being based on the US role of physician assistant, with writing up notes, managing post-operative patients, changing tracheostomy tubes all being typical duties.

Läkarassistent
Som läkarassistent deltar man vanligtvis i avdelningsarbetet med att till exempel undersöka patienter, skriva remisser eller assistera vid operationer.
http://www.slf.se/Utbildning/Grundutbildning/Arbete-och-stud...

What is a Physician Assistant?
Physician assistants (PAs) are health professionals with generalist medical education that allows them to work in a variety of settings. They have ‘dependent’ status - that is they work under the supervision of a fully trained doctor1,2. The profession emerged in the USA in the 1960s and is now being increasingly adopted in other countries.
http://www.abdn.ac.uk/crh/uploads/files/PA Final report Jan ...

Physician Assistant Resident Training Objectives
Patient Care
The PA Resident on the Otolaryngology Surgery Service should demonstrate the ability to:
• Evaluate pre-operative patients
• Manage ward/postoperative patients
• Prioritize patient acuity
• Manage ward emergencies (ex: acute airway obstruction)
• Prioritize clinical responsibilities
• Plan discharge
• Perform the following procedures
• ABG
• Peripheral line/Phlebotomy
• Post-op drain care
• Tracheostomy care
• Tracheostomy tube exchange
• Post-op flap care
• Tracheostomy
• Direct laryngoscopy, assist
• Nasopharyngoscopy, assist
• Airway foreign body removal, assist
http://general.surgery.duke.edu/files/documents/Physician_As...