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I-gel Airway Insertion Overview

Nov 24, 2024

Lecture: Insertion of I-gel Airway

Introduction

  • Presenter: Sam from PrepMedic
  • Topic: Demonstration of inserting an i-gel airway
  • Purpose of I-gel: Superglottic airway that aids ventilation into the lungs

Benefits of I-gel Airway

  • Provides a seal with minimal effort by one person
  • Frees up personnel to perform other tasks in emergencies like cardiac arrest
  • Used as a primary airway or a rescue airway if endotracheal intubation fails

Mechanism

  • The tip sits in the esophagus allowing ventilation into the trachea
  • Offers some airway protection but does not prevent aspiration entirely

Sizing the I-gel

  • Different sizes available: 1, 2, 3, 4, 5
  • Common size for adults: 4
  • Sizing based on Ideal Body Weight (IBW):
    • Males: 50 + 2.3 kg per inch over 5 feet
    • Females: 45.5 + 2.3 kg per inch over 5 feet
  • Ideal body weight is calculated based solely on height

Preparation for Insertion

  • Prepare as for intubation
  • Key equipment:
    • Suction device
    • Bag valve mask (e.g., micro BVM)
    • Capnography device for confirming placement
  • Ensure the patient is ventilated and remove OPA/MPA before insertion
  • Have appropriate sizes ready (a size up and down)

Insertion Process

  1. Suction the oropharynx to clear it
  2. Lubricate the I-gel:
    • Apply medical lubricant, avoid the tip where it could hinder insertion
  3. Insert I-gel:
    • Open patient's mouth without reaching in
    • Insert with tip against hard palate and apply upward pressure
    • Stop upon resistance
  4. Confirm Placement using capnography and lung/epigastrium auscultation
  5. Secure I-gel:
    • Use a bracket, strap, or Thomas II tamer if available
    • Ensure consistent hand placement if no securing device is used

Ventilation

  • Ventilate once every six seconds
  • Squeeze the bag only until chest rise is observed

Failure Points

  • Secretions or vomit can necessitate endotracheal intubation
  • Poor capnography reading or compliance may suggest need for a definitive airway

Removal

  • Simply pull out, no need to deflate

Myths

  • I-gel does not rely on body heat to form a seal

Accessibility

  • Can be performed by a wide range of responders, including EMRs

Conclusion

  • Questions can be left in comments
  • Next session teaser

Full transcript