Anyone using i-gel airway device in BLS pre-hospital setting?

[STXmedic]

Bougie down through the main ventilation port on the King, deflate the cuff and pull the King while leaving the bougie in place, drop the ETT over the bougie, inflate the cuff, walla...good tube!!!

I've never been able to insert the bougie through in an actual patient (no trouble in mannequins or without it being inserted). It always binds up and catches at the distal port. Did you do anything special with the patient?

 

[Handsome Robb]

I've never been able to insert the bougie through in an actual patient (no trouble in mannequins or without it being inserted). It always binds up and catches at the distal port. Did you do anything special with the patient?

I just put a little lube on it and the pt was in a pretty good anatomical position too so I'm sure that helped. To be honest I've only done it once and seen it done a handful of times but I've never seen it get stuck. I could see how that possibility is there though. I

 

[rhan101277]

I just put a little lube on it

That is what she said

 

[jjesusfreak01]

I've never been able to insert the bougie through in an actual patient (no trouble in mannequins or without it being inserted). It always binds up and catches at the distal port. Did you do anything special with the patient?

Never tried it on a real patient, but the problems when I practiced with the manakins seemed to be:

1. Stiff anatomy, the king would bend enough that the bougie got caught.

2. Different sizes and models of king airways are shaped a little differently at the distal port. Some work most of the time, some not at all.

 

[NomadicMedic]

Unless the "LMA Flexible" is meant to be an i-gel, that's not quite a rining endorsement for not considering it's use. Part of the reasoning behind using an i-gel is that it is supposed to seat itself in the esophageus "naturally" without any extra compression of the surrounding tissues.

I can see overinflation of the combitube, king, or LMA being a problem, although the size of the decrease is surprising.

Can't help but wonder if there would have been a difference if each of the airways choosen was used the entire time instead of being switched for an ET tube each time.

Nice small study, but I wouldn't go so far as to call it difinative proof of anything.

Yeah, I certainly wouldn't call it definitive proof, but it certainly is an interesting study. I’ve only seen one other study, done in Japan, which compares ETT to SGA and survival to discharge, with no statistical difference. And how similar is a pig's carotid vascular structure compared to humans?