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Airway

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Has anyone used the i-gel airway? It seems like a much easier option than King or others. No inflatable cuff, less tissue trauma, less chance of aspiration, easy insertion.........

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Thoughts? Experiences?

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Looks like an LMA. I just read two quick abstracts (and briefly read through the studies) comparing the i-gel to two different models of LMAs. One study was pro i-gel. The other was pro LMA. Having never used this device, however, I can't comment on it.

As far as backup airways go I'm not a fan of the LMA in field use. I do like the King tubes. Even Combitubes are ok. (If given the choice between the two I'll take the King.) Given the way things are going it looks like these things may not be the backup airway options for much longer.

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There's a great instructional video on YouTube. Too bad I don't know how to attach it here. It's easy to find. It really shows how easy it is to use and how effective it is.

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We carry them as our backup airway; had to use it a couple times, either as a bridge to intubation or until arrival at the ER.

No major complaints; it can be slightly touchy to get a adequate seal, but that's probably due to using the wrong size and an easy enough fix. Stability...meh. Do a good job securing it and it's ok...and if there is a little forward/backward play in it it shouldn't be a major problem as it will (or should anyway) reseat itself each time. Not an excuse to not tape in properly though.

Anesthesiologists seem to love them, though the environments are different. Personally I think it's fine to use as a backup.

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When we've used them they were great.  Only complaint is that they are weight based and not height based (in ye ol' America it's a problem!).

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On 3/10/2015 at 11:18 AM, paramedicmike said:

I do like the King tubes. Even Combitubes are ok. (If given the choice between the two I'll take the King.)

 

I'm much the fan of King airways over Combitubes as well. If I'm the only medic on a code, I would rather slip the King in & use that as my airway so that I can concentrate on other measures.

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Just throwing this out there. Most services with high ROSC rates still use a plain old ET tube. Seattle and BCAS (within Metro Vancouver) come to mind. They also try to maintain a paired, tiered, and targeted ALS response within metro zones.

Overall skill retention/proficiency haven't been shown their due over the years and it shows. Don't get me wrong, the King is a great back up airway, but it feels like their is an appetite to solve the problem with toys instead of what's really missing; education.

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11 hours ago, rock_shoes said:

Just throwing this out there. Most services with high ROSC rates still use a plain old ET tube. Seattle and BCAS (within Metro Vancouver) come to mind. They also try to maintain a paired, tiered, and targeted ALS response within metro zones.

Overall skill retention/proficiency haven't been shown their due over the years and it shows. Don't get me wrong, the King is a great back up airway, but it feels like their is an appetite to solve the problem with toys instead of what's really missing; education.

Also at issue are high stakes, high skills burden procedures. For real proficiency in procedures like advanced airway security, there is just no substitute for doing it a lot. Just how that happens is another question.

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