Details
Question
- What is the comparative clinical effectiveness and safety of airway management with the i-gel device performed in a pre-hospital setting versus airway management with the i-gel device performed in-hospital by a physician?
- What is the comparative safety of airway management with the i-gel device versus other intubation devices when performed in a pre-hospital setting?
- What is the cost-effectiveness of the i-gel device for airway management?
- What are the evidence-based guidelines for airway management in pre-hospital settings?
Key Message
There was one cluster RCT with good-quality evidence for safety outcomes, and seven evidence based guidelines for airway management. No studies comparing the clinical effectiveness of the i-gel device in a pre-hospital setting or in-hospital by physicians were identified. There were no studies regarding the cost-effectiveness of the i-gel device. In the single RCT, Benger et al. compared the effectiveness and safety profiles of the i-gel with those of tracheal intubation. There was no significant difference between these airway management interventions in terms of clinical effectiveness (measured by modified Rankin Scale scores) or safety (including regurgitation and aspiration).The evidence-based guidelines included recommendations regarding airway management. In brief, it was recommended in one guideline that it requires training to use supraglottic airway devices. Supraglottic devices are recommended in two guidelines if practitioners consider the potential benefits to outweigh the risks. The remaining five guidelines contained recommendations for different types of airway management, ranging from positional changes to laryngeal masks or tracheal intubation depending on the circumstances.