Dr. Peter Antevy’s Handtevy Minute video explains choosing and using the i-gel supraglottic airway across pediatric and adult sizes. He demonstrates device features, preparation (lubrication, preloading a 12 French Salem sump through the device’s suction port when present), insertion and securing techniques (strap with hooks for sizes 3–5; alternative strapping/tape or Coban for smaller sizes), and measurements for Salem sump length (corner of mouth → around ear → xiphoid process). He contrasts size-specific features: size 1 lacks suction port, hooks, and passive oxygenation; sizes 1.5–2.5 have suction but no hooks or passive oxygenation; sizes 3–5 have suction, hooks, and passive oxygenation.
Questions this video answers
12 French Salem sump.
From the corner of the mouth, around the ear, down to the xiphoid process.
Chapters
Hey, everyone, this is Dr. Peter Enteve. Welcome to another edition of the HENT Heavy Minute. Today I want to talk about an airway, specifically the supraglottic airway. Now, as you know, I love the bvm. Basic BLS maneuvers are important, but once you start to advance the airway, consider a supraglottic airway. So let's talk about the Igel, which is what I use in my agencies. And I have here several sizes, which we'll talk about in a minute. But the Igel goes from the youngest children all the way to an adult. So I want to show you the differences here. We'll talk about suction with the eye gel, and then I'm going to take you to the mannequin here. We're going to show you exactly how to utilize this device, exactly with the mannequin at the very end, I'll give you a little graphic on the whiteboard. Okay, so let's start with the largest of the eye gels first. And as soon as you're a size 3, 4, or 5, the eye drill comes in what they call a recess pack. And the reason they have that is because there's a strap that comes with it. So let's open this up and show you what's in the pack here. So the first thing you'll find is lube. That's important. The second thing you'll find is this strap, which is important as well. I'll show you that in a minute. But first and foremost, what I'd like to talk to you about with this eye gel is the following, that the 3, 4, and 5 have these hooks. Number one, they also have a port for suction right here. And then, as you can see here, the eye gel itself does not require any inflation, which is why I like it personally. It just basically kisses the larynx. It just goes right over the airway. And so you really have a really direct path as you're bagging right into the airway. So let's talk first about suction, this lubricant. The first dollop you're going to put on here is going to be right over that hole. That's a very important piece right there. And of course, the Igel itself needs a lot of lubricant right here on the Igel here. So once you have one, two lubricants, the very next step is to take what I would recommend is a Salem sump. A Salem sump, you know, has suction, but it's also vent. It's Also vented. I don't have that here, but I'd recommend a 12 French Salem sump. And now you have to preload this right into that port. So what I'd like you to do, you see, I'm actually putting this all the way through. I'm going past the eye gel just to make sure that it goes through, and then I'm going to bring it back and make it flush. So that's really the very first step that you're going to do here. Now, after you insert the eye gel, before you strap it down, which I'll show you in a minute, then you can actually, you get that Salem sump all the way down. And of course, when you measure, you measure from the corner of the mouth around the ear down to the xiphoid process, and that's how you'd measure that Salem sump. So it's important not to strap down that eye gel before you've actually pushed that Salem sump down to the appropriate distance. Okay, so now our Salem sump is loaded. We have the eye gel gelled up, and we've actually inserted it into the patient. So now the next step is to secure it. So what they've made is they've created this stretch, and this strap is really meant to go right on these hooks here. And then it goes around the patient's head, and you come to the other side and you hook it here. So now you have the ability to actually strap this down behind the patient's head. And so this is really nice. It's very easy to use, but there are some differences. Now, as we move below number three, let's take a look at those. Okay, so now I've gone down to the 1.5. So remember, anything below 3, so even the 2.5. The 2. The 1.5. See that those hooks are not there anymore. That poses a problem with how to secure this Igel once you've inserted it, what it does still have, it still has that port for suction for the Salem sump. Still fits the same 12 French. But now when you add it in, we'll show you now a new way that we're actually using to actually put this thing and secure it. Now let's move down to the smallest one. The smallest one. Now, size one. Remember, this is for a preemie or a newborn only. You can see here that there is no suction port and there are no hooks. So now this is really the most basic of the eye gels. Just remember, it doesn't have those two items Nor does it have that passive oxygenation port. So we'll talk about that in a minute. But let's actually look at how we can put the 1.5 into this child mannequin here. So remember, again, we're going to put lube over the port, and we're going to put lube over the eye gel itself here. Now we're going to take again, this is going to be a Salem sump. You're going to go all the way through at first so you know that it gets through. Go right back to flush. And now we're going to come back and we're going to insert it into the mannequin. So of course, it just inserts straight down until you meet resistance. And that's when, at this point in time, you now push the tube all the way down to the desired length. And so this goes all the way down now until it reaches the exact length that we've measured. And now the question is, how do we secure this? And so what we've learned is that we can take the same strap, we can put it behind the child's head. We can come up here, and we can actually use the hole that's in the strap on one end, and then we can come around, bring this other side around, and we can actually do the same thing here. So now you have an eye gel that's secured with the same exact strap. So that's up until the size 1.5. Now let's move on to this one here. You can't do that with the size one because the holes in the strap don't extend far enough and that strap becomes too big. And so in order to get this thing secured, you have to use either tape or we've actually used Coban successfully on this. I'm hoping that the folks at inner Surgical are watching and we can actually perhaps make a few more holes in that strap, and therefore, we can use that same technique on all of the eye gels. So the next thing I want to show you is a summary chart of everything I've talked about. Let's move to the whiteboard. Okay, so let's just wrap up Size one eye gel, preemine newborn. Importantly, there's no hooks, there's no suction, and there's no passive oxygenation. Again, this is going to be the one that doesn't have any of those features. As you get to a size 1.5. 2.2.5. The suction is there, right? The suction is there, but the hooks aren't. You can see there's no hooks here. And also it doesn't have any of the passive oxygenation at all. And then once you get to the 3, 4 and 5, 3, 4 and 5 have all those three features, suction, hooks and passive oxygenation. So it's important learn about the items that you have a big fan of this inner surgical. Hopefully you can reach out and we can talk about ways to actually strap down that size one again. This has been Dr. Peter Antevi for another edition of the Hantevi Minute. Thank you very much.
