title: Performance of the i-gel™ during pre-hospital cardiopulmonary resuscitation.
abstract: BACKGROUND
  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.
authors: Emergency Medical Service, German Red Cross, Obere Wässere 1, 72764 Reutlingen, Germany. haeske@rettungsdienst-reutlingen.de
authors: David
authors: D
authors: Häske
authors: Benjamin
authors: B
authors: Schempf
authors: Gernot
authors: G
authors: Gaier
authors: Christoph
authors: C
authors: Niederberger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000488:Allied Health Personnel; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation* / Q000379:methods; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000379:methods; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006336:Heart Massage / Q000379:methods; D006801:Humans; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation*; D018570:Risk Assessment; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: CPR; Pre-hospital; Resuscitation; Ventilation; i-gel