Use of i-Gel Supraglottic Airway in a Simulated Cardiac Arrest Resuscitation During Boat Rescue Transport by Los Angeles County Fire Lifeguard Division: A Proof-of-Concept Study
The Los Angeles County Fire Department Lifeguard Division responds to water rescues and medical and dive emergencies across 72 miles of Southern California coastline and Catalina Island. Limited advanced life support resources make cardiac arrest resuscitations logistically challenging during transp...
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Published in | Air medical journal Vol. 43; no. 1; pp. 34 - 36 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
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United States
01.01.2024
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Abstract | The Los Angeles County Fire Department Lifeguard Division responds to water rescues and medical and dive emergencies across 72 miles of Southern California coastline and Catalina Island. Limited advanced life support resources make cardiac arrest resuscitations logistically challenging during transport to shore or the hyperbaric chamber. This proof-of-concept study looked to determine if an i-Gel (Intersurgical Complete Respiratory Systems, Wokingham, Berkshire, UK) supraglottic airway device would either become dislodged or compromise ventilations during prolonged resuscitation at high speeds over open water with an ongoing automatic chest compression device (ACCD).
A simulated resuscitation was performed on the Los Angeles County Lifeguard rescue boat while underway at speeds up to 25 knots. A LUCAS ACCD (Jolife AB, Ideon Science Park, Lund, Sweden) and a size 3 i-Gel were used. The volume of ventilations and depth of compressions were continuously monitored using the AmbuMan Advanced manikin (Ambu, Ballerup, Denmark).
The i-Gel supraglottic airway device delivered appropriate ventilations measuring between 300 and 400 mL/breath when delivered on the upstroke of compression. The i-Gel did not dislodge during transport.
The i-Gel supraglottic airway device appears to provide adequate ventilations without dislodgment during ongoing compressions with an ACCD during high-speed water transport. |
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AbstractList | OBJECTIVEThe Los Angeles County Fire Department Lifeguard Division responds to water rescues and medical and dive emergencies across 72 miles of Southern California coastline and Catalina Island. Limited advanced life support resources make cardiac arrest resuscitations logistically challenging during transport to shore or the hyperbaric chamber. This proof-of-concept study looked to determine if an i-Gel (Intersurgical Complete Respiratory Systems, Wokingham, Berkshire, UK) supraglottic airway device would either become dislodged or compromise ventilations during prolonged resuscitation at high speeds over open water with an ongoing automatic chest compression device (ACCD).METHODSA simulated resuscitation was performed on the Los Angeles County Lifeguard rescue boat while underway at speeds up to 25 knots. A LUCAS ACCD (Jolife AB, Ideon Science Park, Lund, Sweden) and a size 3 i-Gel were used. The volume of ventilations and depth of compressions were continuously monitored using the AmbuMan Advanced manikin (Ambu, Ballerup, Denmark).RESULTSThe i-Gel supraglottic airway device delivered appropriate ventilations measuring between 300 and 400 mL/breath when delivered on the upstroke of compression. The i-Gel did not dislodge during transport.CONCLUSIONThe i-Gel supraglottic airway device appears to provide adequate ventilations without dislodgment during ongoing compressions with an ACCD during high-speed water transport. The Los Angeles County Fire Department Lifeguard Division responds to water rescues and medical and dive emergencies across 72 miles of Southern California coastline and Catalina Island. Limited advanced life support resources make cardiac arrest resuscitations logistically challenging during transport to shore or the hyperbaric chamber. This proof-of-concept study looked to determine if an i-Gel (Intersurgical Complete Respiratory Systems, Wokingham, Berkshire, UK) supraglottic airway device would either become dislodged or compromise ventilations during prolonged resuscitation at high speeds over open water with an ongoing automatic chest compression device (ACCD). A simulated resuscitation was performed on the Los Angeles County Lifeguard rescue boat while underway at speeds up to 25 knots. A LUCAS ACCD (Jolife AB, Ideon Science Park, Lund, Sweden) and a size 3 i-Gel were used. The volume of ventilations and depth of compressions were continuously monitored using the AmbuMan Advanced manikin (Ambu, Ballerup, Denmark). The i-Gel supraglottic airway device delivered appropriate ventilations measuring between 300 and 400 mL/breath when delivered on the upstroke of compression. The i-Gel did not dislodge during transport. The i-Gel supraglottic airway device appears to provide adequate ventilations without dislodgment during ongoing compressions with an ACCD during high-speed water transport. |
Author | Gupta, Puneet Wilhelm, Kelsey Kazan, Clayton Warren, Jonathan |
Author_xml | – sequence: 1 givenname: Jonathan surname: Warren fullname: Warren, Jonathan email: jwarren@dhs.lacounty.gov organization: Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, CA. Electronic address: jwarren@dhs.lacounty.gov – sequence: 2 givenname: Kelsey surname: Wilhelm fullname: Wilhelm, Kelsey organization: Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, CA; Los Angeles County EMS Agency, Santa Fe Springs, CA; Compton City Fire Department, Compton, CA – sequence: 3 givenname: Puneet surname: Gupta fullname: Gupta, Puneet organization: Harbor-UCLA Medical Center, Department of Emergency Medicine, Torrance, CA; Los Angeles County Fire Department, Los Angeles, CA – sequence: 4 givenname: Clayton surname: Kazan fullname: Kazan, Clayton organization: Los Angeles County Fire Department, Los Angeles, CA |
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References | Grunau (10.1016/j.amj.2023.09.008_bib0002) 2020; 324 10.1016/j.amj.2023.09.008_bib0001 Acott (10.1016/j.amj.2023.09.008_bib0005) 2008; 38 Kazan (10.1016/j.amj.2023.09.008_bib0003) 2021; 40 10.1016/j.amj.2023.09.008_bib0004 |
References_xml | – volume: 324 start-page: 1058 year: 2020 ident: 10.1016/j.amj.2023.09.008_bib0002 article-title: Association of intra-arrest transport vs continued on-scene resuscitation with survival to hospital discharge among patients with out-of-hospital cardiac arrest publication-title: JAMA doi: 10.1001/jama.2020.14185 contributor: fullname: Grunau – ident: 10.1016/j.amj.2023.09.008_bib0004 – volume: 38 start-page: 124 year: 2008 ident: 10.1016/j.amj.2023.09.008_bib0005 article-title: Extraglottic airway devices for use in diving medicine - part 3: the i-gelTM publication-title: Diving Hyperb Med contributor: fullname: Acott – volume: 40 start-page: 50 year: 2021 ident: 10.1016/j.amj.2023.09.008_bib0003 article-title: The performance of manual versus mechanical cardiopulmonary resuscitation during a simulated rescue boat transport in cardiac arrest publication-title: Air Med J doi: 10.1016/j.amj.2020.10.007 contributor: fullname: Kazan – ident: 10.1016/j.amj.2023.09.008_bib0001 |
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Title | Use of i-Gel Supraglottic Airway in a Simulated Cardiac Arrest Resuscitation During Boat Rescue Transport by Los Angeles County Fire Lifeguard Division: A Proof-of-Concept Study |
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