Performance of the i-gel™ during pre-hospital cardiopulmonary resuscitation |
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Authors: | David Häske Benjamin Schempf Gernot Gaier Christoph Niederberger |
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Institution: | 1. Emergency Medical Service, German Red Cross, Obere Wässere 1, 72764 Reutlingen, Germany;2. Department of Internal Medicine, Cardiology, Angiology and Intensive Care Medicine, Klinikum am Steinenberg, Steinenbergstrasse 31, 72764 Reutlingen, Germany;3. Department of Anaesthesiology and Intensive Care Medicine, Klinikum am Steinenberg, Steinenbergstrasse 31, 72764 Reutlingen, Germany |
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Abstract: | BackgroundCurrent cardiopulmonary resuscitation (CPR) guidelines recommend airway management and ventilation whilst minimising interruptions to chest compressions. We have assessed i-gel™ use during CPR.MethodsIn 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.ResultsWe 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.ConclusionsThe i-gel™ is an easy supraglottic airway device to insert and enables adequate ventilation during CPR. |
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Keywords: | Resuscitation CPR i-gel Ventilation Pre-hospital |
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