Evidence-Based Practice Nursing Poster Project; I-gel

Colten Nelson

Department of Nursing, Eastern Arizona College

NUR 250: Nursing Four

Sara Lemley, RN, MSN, CNE

November 8th, 2022

1. Introduction and Significance to nursing

1.1.i-gel

1.1.1.The I-gel is a single use airway device

1.1.2.Gets its name from the soft gel-like material it is made from.

1.1.3.The gel conforms with natural body temperature to the perilarngeal

anatomy and places itself over the laryngeal framework without the use

of an inflating cuff.

1.1.4.The risk for compression and displacement trauma are reduced.

1.1.5.The insertion time is immensely decreased which provides shorter

cessation time of CPR.

1.1.6.The I-gel is an airway device inserted into the pharynx without the

need for endotracheal intubation

1. Indications of use

1.1.Airway during resuscitation

1.1.1.Ventilation

1.1.2.Oxygenation
1. Application

1.1.While wearing gloves open package on a flat surface. Take out the protective

cradle containing the device supporting the device between the thumb and index

finger.

1.2.Place a small bolus of a water-based lubricant, onto the middle of the smooth

surface of the protective cradle and lubricate the back, sides and front of the cuff

with lubricant.

1.3.Inspect the device for foreign bodies or lubricant obstructing the distal opening.

Place back into the protective cradle.

1.4.Remove the i-gel from the protective cradle. Grab the lubricated i-gel along the

integral bite block. Position the device so that the i-gel cuff outlet is facing towards

the chin of the patient. The patient should have the head extended and neck flexed.

The chin should be gently pressed down before proceeding. Begin inserting the soft

tip into the mouth of the patient towards the hard palate.

1.5.Insert the device down and back along the hard palate with a continuous but gentle

push until a definitive resistance is felt. The tip of the airway should be located into

the upper esophageal opening and the cuff should be located against the laryngeal

framework. The incisors should be resting on the integral bite block.

1.6.The i-gel should be taped down from ‘maxilla to maxilla’.

1. Evidence based research; Study 1

1.1.The study was composed of 31 and 24 cases following the insertion of I-gels and

their success rates on insertion.

1.2.The Study found that it took 1 attempt to place an i-gel in 31 cases and 2 attempts

to place an i-gel in 3 cases. All insertion attempts were successful through the

second insertion attempt.

1. Evidence based research; Study 2

1.1.The study was composed of emergency care on the rapid insertion of an airway

and the insertion times of different forms of airway management.

1.2.The study discusses the essential need for placing an airway rapidly to ensure

patency during CPR. The chest compressions should only be haltered briefly for

the placement of an airway. The study found that the placement of an i-gel had

shorter insertion times then other devices.

1. Evidence based research; Study 3

1.1.The study compared i-gels with laryngeal mask airways (LMA) where the I-gel

showed 100% first intubation attempt success. Where as the LMA showed 82.4%

success with the first attempt at an airway.

1.2.The study also found that the shortest median time to intubate was with an I-gel.

1.3.The study found an immense difference in success rate of intubation with the i-gel

at 94.1% then with the LMA at 73.5%.

1. Website: I-gel Bibliography Published studies, case reports and correspondence

1.1.The studies within the bibliography found multiple findings including

1.1.1.I-gels have a lower insertion time

1.1.2.Lower instance of blood staining on removal

1.1.3.Less frequent findings of sore throat post removal

1.1.4.Higher success rate upon insertion

1.1.5.I-gel was consistently positioned over the laryngeal inlet

1.1.6.The gel-like material of the device conformed to the perilaryngeal

anatomy

1.1.7.Lower instances of dysphagia post removal

1. Additional research to be considered

1.1.More specific studies should be obtained on the post procedure risks and

complications with i-gel use in airways

1.2.More studies should be conducted on the effectiveness of the measuring technique

in i-gels

References

An, Nam, S. B., Lee, J. S., Lee, J., Yoo, H., Lee, H. M., & Kim, M.-S. (2017).
Comparison of the i-gel and other supraglottic airways in adult manikin studies:
Systematic review and meta-analysis. Medicine (Baltimore), 96(1), e5801–e5801.
https://doi.org/10.1097/MD.0000000000005801

Intersurgical. (2018, February 5). Gel® Supraglottic Airway. I-gel Bibliography.

Retrieved October 15, 2022, from https://us.intersurgical.com/products/airway-
management/i-gel-supraglottic-airway#downloads

Komasawa, Nishihara, I., Tatsumi, S., & Minami, T. (2014). Prewarming of the i-gel
facilitates
successful insertion and ventilation efficacy with muscle relaxation: a randomized study.
Journal of Clinical Anesthesia, 26(8), 663–667.
https://doi.org/10.1016/j.jclinane.2014.08.009

Komasawa, & Minami, T. (2016). A proposal of an effective coping approach to

esophageal intubation. The American Journal of Emergency Medicine, 35(5), 787–787.
https://doi.org/10.1016/j.ajem.2016.11.047