i-gel Resus Pack

How does the i-gel create a seal without an inflatable cuff?

The i-gel uses a non-inflatable cuff made from soft medical-grade thermoplastic elastomer (TPE) — a gel-like material that conforms to the individual contours of the patient's pharyngeal, laryngeal, and perilaryngeal anatomy upon insertion. The material's softness and elasticity create a close anatomical seal passively, without the need to inflate a cuff with air. This eliminates the inflation step and the risk of seal failure from cuff overinflation or underinflation, and reduces compression trauma compared to high-pressure inflatable cuffs.

How do I select the correct i-gel size?

i-gel size is selected primarily by patient weight: Size 3 (Yellow) for small adults 30–60 kg, Size 4 (Green) for medium adults 50–90 kg, and Size 5 (Orange) for large adults 90+ kg. Size 4 is the most commonly used for average adult patients. Each size is color-coded on the cradle packaging for rapid identification. When patient weight is unknown, estimate based on body habitus — Size 4 is appropriate for the majority of average-sized adults.

What is the gastric channel in the i-gel used for?

The i-gel has an integrated gastric channel — a separate lumen that runs alongside the main airway conduit. The 12Fr suction tube included in the Resus Pack is passed through this channel into the esophagus/stomach to allow gastric decompression (suctioning of gastric contents) without removing the i-gel from the airway. This reduces aspiration risk during prolonged resuscitation when gastric regurgitation is a concern. The gastric channel is a second-generation SGA feature that the original i-gel added as a key safety advantage.

Is the i-gel appropriate for use in TCCC/combat medicine?

Per the 2024 CoTCCC airway guidelines, extraglottic airways (EGAs) including the i-gel are not superior to BVM ventilation for non-cardiac-arrest combat trauma patients, and the evidence suggests BVM may provide better outcomes in many tactical scenarios. Without RSI (sedation and paralysis), EGA placement requires a deeply comatose patient — a relatively uncommon presentation in alive combat casualties. The i-gel is best used in TACEVAC/prolonged field care contexts by advanced providers under specific medical director authorization, rather than as routine first-line tactical field care.

Can the i-gel be used for intubation?

The original i-gel (not the Resus Pack specifically) can be used as an intubation conduit with fiberoptic guidance. The i-gel Resus Pack is designed for emergency resuscitation airway management rather than guided intubation. If intubation through the i-gel is required, it can be attempted with appropriate airway exchange equipment, but this is an advanced technique requiring specific training beyond standard EGA insertion skills.