Performance of the i-gel™ during pre-hospital cardiopulmonary resuscitation
Resuscitation. Volume 84, Issue 9, September 2013, Pages 1229–1232
Current cardiopulmonary resuscitation (CPR) guidelines recommend airway management and ventilation whilst minimising interruptions to chest compressions. We have assessed i-gel™ use during CPR.
Methods
In an observational study of i-gel™ use during CPR we assessed the ease of i-gel™ insertion, adequacy of ventilation, the presence of a leak during ventilation, and whether ventilation was possible without interrupting chest compressions.
Results
We analysed i-gel™ insertion by paramedics (n = 63) and emergency physicians (n = 7) in 70 pre-hospital CPR attempts. There was a 90% first attempt insertion success rate, 7% on the second attempt, and 3% on the third attempt. Insertion was reported as easy in 80% (n = 56), moderately difficult in 16% (n = 11), and difficult in 4% (n = 3). Providers reported no leak on ventilation in 80% (n = 56), a moderate leak in 17% (n = 12), and a major leak with no chest rise in 3% (n = 2). There was a significant association between ease of insertion and the quality of the seal (r = 0.99, p = 0.02). The i-gel™ enabled continuous chest compressions without pauses for ventilation in 74% (n = 52) of CPR attempts. There was no difference in the incidence of leaks on ventilation between patients having continuous chest compressions and patients who had pauses in chest compressions for ventilation (83% versus 72%, p = 0.33, 95% CI [−0.1282, 0.4037]). Ventilation during CPR was adequate during 96% of all CPR attempts.
Conclusions
The i-gel™ is an easy supraglottic airway device to insert and enables adequate ventilation during CPR.
http://www.sciencedirect.com/science/article/pii/S0300957213002578