Emergency airway management by paramedics: comparison between standard endotracheal intubation, laryngeal mask airway, and I-gel.

The aim of this study was to investigate whether briefly trained paramedics would be able to successfully intubate by endotracheal intubation (ETI) and using the laryngeal mask airway (LMA) and the I-gel in a manikin model. After the completion of a questionnaire, a brief educational session, and presentation of ETI, LMA, and I-gel, 72 paramedics were randomly allocated to intubate an adult manikin. The success rate for I-gel was higher than that for LMA (P<0.001) and ETI (P<0.001), and the insertion time for I-gel was significantly shorter than that for LMA (P<0.001) or during ETI (P<0.001). There was a statistically significant association between the experience level of paramedics and insertion time only for the LMA (P=0.012). In addition, the mean insertion time values were significantly affected by the accuracy of the answers to the theoretical questions (P<0.05 for all questions). Paramedics should lay greater emphasis on airway management using supraglottic devices, especially I-gel because of its shorter time of insertion.