Is an i-gel® supraglottic airway useful for airway rescue in the community?

Abstract

Objective: To ascertain whether an i-gel® (Intersurgical UK) supraglottic airway is suitable for newborn resuscitation in the community. Method: Fifty five community midwives were invited to participate in this study during their continuing professional development (CPD) training time over a 4 month period. Twenty of the midwives were able to participate during this time frame. The midwives were asked to manage a newborn resuscitation scenarios using 2 differing techniques: Bag valve mask with a Guedel airway (control) and a bag with an i-gel®. Results: Time to first breath was quicker using the i-gel® compared to bag valve mask and Guedel airway. There was no significant difference in duration of inflation breaths between the two techniques. Participants generated higher inflation pressures using i-gel® with a mean of 40cm H2O as opposed to 34cm H2O with the bag valve mask and Guedel airway. Conclusion: The time to first breath is considerably shorter using an i-gel® although airway pressures were significantly higher. Further investigation is needed before it could be recommended for clinical use, specifically to investigate the increased airway pressures and the true rate of failure.