Failure to ventilate with supraglottic airways after drowning

Area of Science:

• Emergency Medicine
• Resuscitation Science
• Airway Management

Background:

• Supraglottic airways (SGAs) are recommended for resuscitation due to rapid insertion.
• Drowning victims present unique airway challenges requiring potentially high ventilation pressures.

Observation:

• This study reports the failure of i-gel and Ambu AuraOnce supraglottic airways in a drowning victim.
• Failure was linked to altered lung physiology post-submersion and water inhalation.

Findings:

• Ventilation pressures up to 40 cmH2O may be required to address hypoxemia in drowning victims.
• The low leak pressures of many supraglottic airways may be insufficient for effective ventilation in these cases.

Implications:

• Supraglottic airway use in drowning victims might lead to inadequate lung ventilation.
• Potential for gastric insufflation exists if ventilation pressures exceed device limits.
• Further research is needed to determine optimal airway management strategies for drowning resuscitation.