I-Gel Supraglottic Application

• Indication

  1. Unconscious pt requiring airway support and/or airway protection
• Contraindication

  1. Conscious pt
• Considerations

  1. Insert with care in cases of severe facial and airway trauma
  2. Do not attempt insertion in cases of trismus (spasm of the jaw muscles, causing the mouth to remain tightly closed) or limited mouth opening
  3. Insert with care in patients with fragile or vulnerable dental work
  4. Remove ill-fitting dentures before attempting insertion.
• Sizing

  
• Preparing Patient

  1. Pt should always be in 'sniffing' position -> Head extended and neck flexed

  
• Pre-insertion preparation

  Step 1. Inspect packaging -> no damage

  Step 2. Remove protective cradle from package, remove i-gel

  
• Pre-insertion preparation

  Step 3 Lubricate i-gel

  1. Support i-gel in one hand
  2. Place small amount of lubricant onto middle of cradle
  3. Lubricate back, sides, and front of i-gel
  4. Place i-gel back onto cradle

  
• Insertion technique

  Step 1. Grasp lubricated i-gel via the end/bite-block

  Step 2. Position i-gel with outlet facing towards chin of pt

  • Pistol grip used to open airway to assist insertion
  • DO NOT APPLY EXCESSIVE FORCE

  Step 3. Chin pressed inferiorly, opening mouth before inserting i-gel

  
• Insertion technique

  Step 4 - Introduce leading soft tip into mouth in a direction towards hard palate

  Step 5 - Glide i-gel downwards and backwards, with continuous but gentle push until definitive resistance is felt

  
• Insertion technique

  Step 6 - Secure i-gel with cotton tape

  
• Considerations

  1. Sometimes a feel of “give-way” is felt before the end point resistance is met. This is due to the passage of the bowl of the i-gel through the faucial pillars (pharyngo-epiglottic folds).
  2. Once resistance is met and the teeth are located on the integral bite block, do not repeatedly push I-gel down or apply excessive force.
  3. No more than three attempts in one patient should be attempted.