WWYD: Butane inhalation & ignition

[NomadicMedic]

You don’t have to preload the king with a gastric tube. You can place the OG after the King is inserted.

The King also advertises that you can place a bougie down the main BVM port and it should be directed towards the glottic opening at which time you could essentially do a tube exchange via bougie.

The Kings have fallen out of favor in the past couple of years due to overpressure in the balloon causing restricted carotid arteries and jugular vein drainage. There are several other popular options out now with the iGel being one of the main ones, that also has its own issues.

What issues does the igel have?

The only problem that I was aware of was that of an iGel getting displaced because it was held incorrectly with a Thomas tube holder. You absolutely have to use the elastic band that comes with the iGel to secure it. It needs some downward pressure to ensure it stays seated against the glottis.

 

[DesertMedic66]

What issues does the igel have?

The only problem that I was aware of was that of an iGel getting displaced because it was held incorrectly with a Thomas tube holder. You absolutely have to use the elastic band that comes with the iGel to secure it. It needs some downward pressure to ensure it stays seated against the glottis.

We have had some issues with the gel in the desert heat and also in some super hyperthermic patients. The downward pressure that you identified is also an issue. If you use the elastic band you may have to readjust it during use as the band gets easily stretched. We stopped using the bands and switched to the Thomas Select tube holder.

The other issue is that the packaging is ridiculously bulky. So we have to store all the iGels in their own separate bag because they won’t fit in our backup airway kit.

 

[FiremanMike]

We have had some issues with the gel in the desert heat and also in some super hyperthermic patients. The downward pressure that you identified is also an issue. If you use the elastic band you may have to readjust it during use as the band gets easily stretched. We stopped using the bands and switched to the Thomas Select tube holder.

The other issue is that the packaging is ridiculously bulky. So we have to store all the iGels in their own separate bag because they won’t fit in our backup airway kit.

Good point about the packaging taking up far too much space, but if I recall correctly - the king packaging wasn't much better.

Just get a McGrath and get better at intubating... (I kid)

 

[DesertMedic66]

Good point about the packaging taking up far too much space, but if I recall correctly - the king packaging wasn't much better.

Just get a McGrath and get better at intubating... (I kid)

The king packaging was much better than the iGel. The king was just simply the airway inside the paper/plastic package so it was much more comparable to a normal ETT.

We carry the CMACs and have over a 94% first pass success rate