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iGEL vs laryngeal tube for airway management during a normal airway scenario

Published:February 27, 2018DOI:https://doi.org/10.1016/j.ajem.2018.02.029
      We read with a great interest the article entitled “Which option for ventilation is optimal for resuscitation performed by nurses? Pilot data” [
      • Kaminska H.
      • Gawel W.
      • Wieczorek W.
      Which option for ventilation is optimal for resuscitation performed by nurses? Pilot data.
      ]. The authors in this article compare the effectiveness of ventilation using a self-expanding bag with a face mask and a self-expanding bag with a connected iGEL supraglottic device. The current American Heart Association guidelines allow the usage of supraglottic devices for ventilation during resuscitation. Additionally after verifying the correctness of the device installation they allow for continuous chest compressions without the need for breaks to perform breaths [
      • Sip M.
      • Dabrowska A.
      • Prucnal K.
      • Puslecki M.
      • Klosiewicz T.
      Supraglottic devices—future or everyday life?.
      ]. Admittedly, the Kaminska et al. [
      • Kaminska H.
      • Gawel W.
      • Wieczorek W.
      Which option for ventilation is optimal for resuscitation performed by nurses? Pilot data.
      ] was carried out in simulated cardiopulmonary resuscitation conditions, however, as indicated by numerous studies supraglottic ventilation devices are also applicable in other situations, such as intubation of a traumatic patient [
      • Dodd K.W.
      • Driver B.E.
      • Reardon R.F.
      Trauma patients presenting with a King laryngeal tube™ in place can be safely intubated in the emergency department.
      ] or during face-to-face intubation [
      • Bielski K.
      • Smereka J.
      • Ladny J.R.
      • Szarpak L.
      A comparison of the Macintosh laryngoscope and blind intubation via I-gel in intubating an entrapped patient: a randomized crossover manikin study.
      ]. The effectiveness of ventilation devices was also compared with numerous video laryngoscopes, where the analyzed parameters were: effectiveness of respiratory protection and ventilation by SADs. There were also “blind intubation” attempts where supraglottic ventilation devices were also used as a guide for the endotracheal tube [
      • Kurowski A.
      • Hryniewicki T.
      • Czyżewski L.
      • Karczewska K.
      • Evrin T.
      • Szarpak Ł.
      Simulation of blind tracheal intubation during pediatric cardiopulmonary resuscitation.
      ,
      • Ladny J.R.
      • Bielski K.
      • Szarpak L.
      • Cieciel M.
      • Konski R.
      • Smereka J.
      Are nurses able to perform blind intubation? Randomized comparison of I-gel and laryngeal mask airway.
      ,
      • Smereka J.
      • Szarpak L.
      • Ladny J.R.
      The LMA Fastrach® as a conduit for endotracheal intubation during simulated cardiopulmonary resuscitation.
      ]. To sum up the aforementioned studies the supraglottic ventilation devices are characterized by high effectiveness of airway patency protection and short time of performing the procedure. The search for new methods of maintaining the airway patency takes a special place in emergency medicine as the rapid execution of these procedures is crucial for the patient's survival.
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