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

Authors

Santiago Peña

Published in

Military medicine. Apr 26, 2026. Epub Apr 26, 2026.

Abstract

Airway obstruction remains a leading cause of preventable death on the battlefield. Extraglottic airway devices are recommended for emergent ventilation when definitive airway management is impractical in austere and prehospital environments.
To compare the performance of the i-gel and King LT-D when placed by combat medics under simulated tactical conditions incorporating physical exertion and combat equipment.
Prospective randomized crossover study of active-duty combat medics performing a standardized react-to-contact exertion protocol while wearing full combat gear, followed by placement of both devices on a high-fidelity manikin. The primary outcome was time to successful ventilation. Secondary outcomes included first-attempt success and device preference.
Forty participants completed the protocol. The i-gel was placed significantly faster than the King LT-D (mean difference approximately 34.6 seconds; P < .001). First-attempt success (97.5% vs 87.5%) and user preference (90%) favored the i-gel. No significant difference in delivered tidal volume was observed.
Under simulated tactical conditions, the i-gel enabled faster and more reliable airway placement than the King LT-D. Its simplified, cuffless design may offer advantages under physiologic stress, supporting current guideline recommendations for frontline airway management in military and other austere environments.

PMID:
42035469
Bibliographic data and abstract were imported from PubMed on 27 Apr 2026.

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