Performance of the i-gel™ during pre-hospital cardiopulmonary resuscitation

Background: Current cardiopulmonary resuscitation (CPR) guidelines recommend airway management and ventilation whilst minimising interruptions to chest compressions. We have assessed i-gel (TM) use during CPR. Methods: In an observational study of i-gel (TM) use during CPR we assessed the ease of i-gel (TM) 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 (TM) 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 (TM) 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 (TM) is an easy supraglottic airway device to insert and enables adequate ventilation during CPR. (C) 2013 Elsevier Ireland Ltd. All rights reserved.