Pre-hospital i-gel blind intubation for trauma: a simulation study

Area of Science:

• Emergency Medicine
• Airway Management
• Trauma Care

Background:

• Securing a definitive airway is critical in pre-hospital trauma care.
• Blind intubation techniques using supraglottic airway devices are alternatives when direct laryngoscopy is challenging.

Purpose of the Study:

• To evaluate the efficacy of i-gel blind intubation (IGI) as a rescue device for definitive airway management.
• To compare IGI with the laryngeal mask airway Fastrach and Macintosh laryngoscope (MCL) in pre-hospital trauma settings.

Main Methods:

• A prospective randomized crossover study involving 18 paramedics.
• Comparison of intubation performance (time and success rate) of IGI, Fastrach, and MCL.
• Intubations were performed at both ground- and stretcher-level patient positions.

Main Results:

• Patient position did not significantly impact intubation performance.
• IGI demonstrated the shortest intubation time among the three techniques in both positions.
• IGI achieved a significantly higher success rate than MCL (OR 3.6; P=0.03).

Conclusions:

• Patient positioning does not affect intubation performance in this context.
• Blind intubation with supraglottic airway devices, particularly IGI, is faster than with MCL.
• IGI is an effective rescue device for definitive airway management in pre-hospital trauma care.