Performance of the i-Gel Versus King LT-D by Combat Medics Under Simulated Tactical Conditions: A Prospective Randomized Crossover Study.

In 30 seconds

This prospective randomized crossover study compared i-gel and King LT-D placement by active-duty combat medics after exertion while wearing full combat gear, using a high-fidelity manikin. The primary outcome was time to successful ventilation. Among 40 participants, i-gel placement was faster, with a mean difference of approximately 34.6 seconds (P < .001). First-attempt success also favored i-gel (97.5% vs 87.5%), as did user preference (90%). Delivered tidal volume did not differ significantly. The findings apply to simulated tactical conditions rather than clinical airway management in patients.

Key findings

• i-gel placement was faster than King LT-D placement, with a mean difference of approximately 34.6 seconds (P < .001).
• First-attempt success was 97.5% with i-gel versus 87.5% with King LT-D.
• User preference favored i-gel (90%); delivered tidal volume showed no significant difference.

Why it matters

Rapid, reliable ventilation is important when definitive airway management is impractical in austere or prehospital settings. This simulation suggests that device performance under exertion and encumbrance may differ, and that i-gel placement may be quicker and more successful on the first attempt in these conditions. The results inform understanding of device usability but do not establish comparative effectiveness in patients.

What to keep in mind

The comparison used a high-fidelity manikin under simulated conditions, so performance may not reflect airway management in patients.