In reply to maisie:
> They're the supraglottic thingies, yes? I must confess, the principle of these has always confused me. We have a broadly similar device for small furries - which I've never used, but a mate has promised to show me - as they're complete b*st*rds to intubate (for most of us), but the pharyngeal anatomy is prone to collapse under anaesthesia, causing airway occlusion. Is this such a problem in people? Recent resusc guidelines have been moving progressively away from any kind of positive ventilation via the airways, so I'm kind of lost as to the usefulness of these devices in people. Certainly, I can't see a benefit where airways are blocked BELOW the larynx, and above that you're going to be maintaining airway through chest compression.
igels are great inventions. They will keep a clear airway, you can put a nasogastric tube down them and any idiot can put one in. It basically goes - lube if you have it, otherwise some other fluid will work, press down throat until it goes no further. In fact they are so good if they were invented before the ET tube I'm fairly certain the amount of endotracheal intubations would be very close to zero.
As for CPR good quality chest compression come before ventilation but as soon as possible you need a good airway device to keep the airway open and ventilating. The amount of air exchange you get with chest compressions is inadequate for any length of time longer than it takes to get an ambulance in a major city, let alone on a hill. The other advantage is that you can stick an igel in without disturbing the c-spine and you won't need fingers of steel to keep the jaw thrust for the whole time. Besides, if you have airway obstruction below the larynx nothing short of a good surgeon will help you.
Mine consists of some antiseptic wipes, a few small plasters, some fabric tape, an army field dressing, a pack of matches (does no one else have this in their med kit?), a couple of safety pins, a pair of sturdy scissors, cling film, duct tape, super glue and some pain killers (paracetamol and tramadol) and a single suture.
If it was a bigger trip I'd add a minor operation kit (a pair of forceps, straight and curved scissors, scalpel, needle holder in a sterile pack), a couple of sutures, local anaesthetic, local with adrenaline, a couple of syringes and needles, an orange cannula or two, a couple of dressings in addition to more drugs like antibiotics and other pain killers.