Supraglottic Airway Aids Pre-Hospital Resuscitation

A novelsupraglottic airway device (SAD) creates a non-inflatable anatomical seal of the pharyngeal, laryngeal, and peri-laryngeal structures.

The Intersurgical (Wokingham, United Kingdom) i-gel second-generation SAD is based on a cuff that creates an anatomical seal during routine or emergency anesthesia, intubation with fiberoptic guidance, and for resuscitation. The gel-like, non-inflatable cuff is made of a styrene ethylene butadiene styrene (SEBS), a soft thermoplastic elastomer that averts compression trauma by mimicking the shape and contour of perilaryngeal anatomy. The cylindrical airway tube is contained within a buccal cavity stabilizer anatomically widened and concaved to eliminate the potential for rotation.

A gastric channel provides an early warning of regurgitation, facilitates venting of gas from the stomach, and allows passing of a suction tube to empty the stomach contents. Also available is an O2 Resus Pack, which incorporates an oxygen port for passive oxygenation, as part of cardiocerebral resuscitation (CCR) protocols. The O2 Resus Pack has all the advantages of the standard i-gel, along with everything required to prepare, insert, and secure the device in one pack. A bite block and epiglottic rest are also integrated into the device. The i-gel is available in three adult and four pediatric sizes, each identified by a color-coded polypropylene protective cradle.

“I came to the UK in 1990 to further my experience in anesthesia and started working for the Royal Airforce Hospitals and various NHS trusts. I took time off work and sold my properties to make this device and by the grace of Allah, it has been a success,” said i-gel inventor Muhammed Aslam Nasir, MD. “Now, this device is sold in over 90 countries and has been a revolution in the medical field. I am pleased that this device is now used five times every minute and this itself is a great honor for me, especially so because it's helping to save lives.”

Supraglottic airway devices are used to keep the upper airway open for unobstructed ventilation. First-generation SADs replaced endotracheal intubation and facemasks in 40% of general anesthesia (GA) cases due to their versatility and ease of use. Second-generation devices have further improved efficacy and utility by incorporating design changes that provide more dependable positive-pressure ventilation, are better able to act as conduits for tracheal tube placement, and have a reduced risk of pulmonary aspiration of gastric contents.