***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We performed a prospect i ve , r and omised trial comparing the i‐gelTM with the LMA ClassicTM in children undergoing general anaesthesia . Ninety‐nine healthy patients were r and omly assigned to either the i‐gel or the LMA Classic . The outcomes measured were airway leak pressure , ease of insertion , time taken for insertion , fibreoptic examination and complications . Median ( IQR [ range ] ) time to successful device placement was shorter with the i‐gel ( 17.0 ( 13.8−20.0 [ 10.0−20.0 ] ) s ) compared with the LMA Classic ( 21.0 ( 17.5−25.0 [ 15.0−70.0 ] ) s , p = 0.002 ) . There was no significant difference in oropharyngeal leak pressure between the two devices . A good fibreoptic view of the glottis was obtained in 74 % of the i‐gel group and in 43 % of the LMA Classic group ( p < 0.001 ) . There were no significant complications . In conclusion , the i‐gel provided a similar leak pressure , but a shorter insertion time and improved glottic view compared with the LMA Classic in children Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND In 2005 the European Resuscitation Council ( ERC ) published a revised version of the guidelines for Advanced Life Support ( ALS ) . One of the aims was to reduce the time without chest compression in the first period of cardiac arrest ( no-flow-time ; NFT ) . We evaluated in a manikin study the influence on NFT using the single use laryngeal tube with suction option ( LTS-D ) compared to single use I-gel for emergency airway management . METHODS A r and omised prospect i ve study with 200 paramedics who performed st and ardised simulated cardiac arrest management in a manikin . RESULTS The use of the LTS-D did not significantly reduce NFT compared with the I-gel ( 104.7s vs. 105.1s ; p>0.05 ) . The LTS-D was inserted as fast as the I-gel ( 10.4s vs. 9.3s ; p>0.05 ) . The LTS-D was correctly positioned by 98 % of the participants on the first attempt compared to 96 % with the I-gel . During the cardiac arrest simulation , establishing and performing first ventilation took an average of 40.5s with the LTS-D compared to 40.9s with the I-gel . CONCLUSION In our manikin study , NFT was comparable using the LTS-D and the I-gel . Therefore , for personnel not experienced in tracheal intubation , the LTS-D and the I-gel seem to be equal alternatives in establishing the airway during cardiac arrest . However , relevant clinical studies are appropriate because any change in guidelines in this area must be based on clinical evidence PURPOSE This prospect i ve , r and omized trial was conducted to establish whether the pediatric laryngeal mask airway ( LMA ) could be used without any concerns for abnormally high intra-cuff pressure when a cuff of the LMA was inflated with half the maximum recommended inflation volume or the resting volume before insertion . BASIC PROCEDURES Eighty children 0 to 9 years of age and weighing of 5 to 30 kg scheduled for general anesthesia were included . Before insertion , the cuff of the LMA was filled with half the maximum recommended inflation volume in the Half volume group , or the resting volume by opening the pilot balloon valve to atmospheric pressure in the Resting volume group . After insertion of the LMA , intra-cuff pressure , oropharyngeal leak pressure , and leakage volume were investigated . MAJOR FINDINGS The Half volume group showed lower mean intra-cuff pressure than the Resting volume group ( 49.6 ± 12.1 cm H(2)O vs 58.1 ± 13.8 cm H(2)O , P = .005 ) . There was no difference in oropharyngeal leak pressure ( 22.1 ± 5.8 vs 21.7 ± 5.1 cm H(2)O , P = .757 ) or leakage volume between the Half volume group and the Resting volume group ( 0.13 ± 0.13 ml/kg vs 0.11 ± 0.12 ml/kg , P = .494 ) under spontaneous respiration . CONCLUSIONS Both methods of the LMA cuff inflation before insertion provided an acceptable range of intra-cuff pressure with adequate pharyngeal sealing without any intervention after insertion INTRODUCTION Endotracheal intubation ( ETI ) is the most widespread method for emergency airway management . Several studies reported that ETI requires considerable skill and experience and if performed incorrectly , may result in serious adverse events . Unrecognized tube misplacement or oesophageal intubation is associated with high prehospital morbidity . This study investigates the usability of supraglottic airway devices compared to ETI and the skill retention of 41 previously inexperienced paramedics following training using a manikin model . METHODS 41 paramedics participated in this study . None had prior experience in airway management , apart from bag-valve ventilation . After a st and ardised audio-visual lecture lasting 45min , the paramedics participated in a practical demonstration using the advanced patient simulator SimMan ( ® ) ( Laerdal Medical , Stavanger , Norway ) . Afterwards , paramedics were instructed to perform airway-management using seven different techniques to secure the airway ( ETI , Laryngeal mask unique [ LMA ] , Proseal , Laryngeal tube disposable [ LT-D ( ® ) ] , I-Gel ( ® ) , Combitube ( ® ) , and EasyTube ( ® ) ) following a r and omized sequence . Participants underwent re assessment after 3 months without any further training or practice in airway-management . RESULTS During the initial training session , ETI was successfully performed in 78 % of cases , while 3 months later the success rate was 58 % . For the supraglottic airway devices , five out of six were successfully used by all paramedics at both time points , the exception being Proseal ( ® ) . Our data show successful skill retention ( success rate : 100 % ) after 3 months for five out of six supraglottic airway devices . Time to ventilation ( T3 ) was significantly less for LMA , LT-D ( ® ) and I-Gel ( ® ) at all time points compared to ETI . CONCLUSION ETI performed by inexperienced paramedics is associated with a low success rate . In contrast , supraglottic airway devices like LMA , LT-D ( ® ) , I-Gel ( ® ) , Combitube ( ® ) and EasyTube ( ® ) are fast , safe and easy-to-use . Within the limitations of a manikin- study , this study suggests that inexperienced medical staff might benefit from using supraglottic airway devices for emergency airway management PURPOSE This single-center , prospect i ve , r and omized , double-blind , 2-arm , parallel group comparison trial was performed to establish whether the adult-sized laryngeal mask airway ( LMA ) Classic ( The Laryngeal Mask Company Ltd , Henley-on-Thames , UK ) could be used safely without any consideration of cuff hyperinflation when a cuff of the LMA Classic was inflated using half the maximum inflation volume or the resting volume before insertion of device . BASIC PROCEDURES Eighty patients aged 20 to 70 years scheduled for general anesthesia using the LMA Classic were included . Before insertion , the cuff was partially filled with half the maximum inflation volume in the half volume group or the resting volume created by opening the pilot balloon valve to equalize with atmospheric pressure in the resting volume group . Several parameters regarding insertion , intracuff pressure , airway leak pressure , and leakage volume/fraction were collected after LMA insertion . MAJOR FINDINGS The LMA Classic with a partially inflated cuff was successfully inserted in all enrolled patients . Both groups had the same success rate of 95 % at the first insertion attempt . The half volume group had a lower mean intracuff pressure compared with the resting volume group ( 54.5 ± 16.1 cm H2O vs 61.8 ± 16.1 cm H2O ; P = .047 ) . There was no difference in airway leak pressure or leakage volume/fraction between the 2 groups under mechanical ventilation . CONCLUSIONS The partially inflated cuff method using half the maximum recommended inflation volume or the resting volume is feasible with the adult-sized LMA Classic , result ing in a high success rate of insertion and adequate range of intracuff pressures Objective Airway management is of utmost importance in critical patients , for whom endotracheal intubation remains the gold st and ard . However , it is a difficult skill to acquire and success rates in novices are unacceptably low . Supraglottic devices constitute promising alternatives . The aim of this study was to assess the use of laryngeal mask airway ( LMA ) classic LMA ( cLMA ) and a relatively new supraglottic device , the i-gel , in experienced and novice doctors in a manikin setting . Methods The study population comprised 116 doctors . After a brief educational session and presentation of cLMA and i-gel , participants were r and omly allocated to insert both devices in an adult manikin . Insertions were performed using a size-4 cLMA and a size-4 i-gel . The primary endpoints were the success rate for each device and the duration of the insertion attempt . Secondary endpoint was the perception of ease of use with each device . Results First attempt success rate was 90.5 % for i-gel and 63.8 % for cLMA ( P<0.001 ) . I-gel use reduced insertion times ( 13.32±4.99 s vs. 17.99±6.87 s , P<0.001 ) and was related with significantly higher first attempt success rates than cLMA in novices ( 90 vs. 48.3 % , P<0.001 ) . In addition , i-gel use provided almost equal success rates for experienced and novice doctors ( 91 vs. 90 % , P = not significant ) , whereas cLMA use result ed in significantly lower success rates for novices ( 48.3 vs. 80.4 % , P<0.001 ) . Conclusion In this manikin setting i-gel significantly improved success rates and insertion time compared with cLMA . Most importantly , i-gel use result ed in high first pass success rates for novice doctors , equal to those achieved by experienced doctors Aims Endotracheal intubation ( ETI ) and basic ventilation techniques ( i.e. mouth-to-mouth/nose , bag-valve-mask ventilation ) require skills and training . As an alternative , supraglottic airway devices ( SAD ) are efficient and technically easy to insert . We therefore evaluated the time to ventilation , success rate , and skill retention for various airway management approaches by medical laypersons using a manikin model . Methods Fifty medical laypersons with no previous experience whatsoever in airway management or resuscitation were enrolled . All participants received a 1-h-long theoretical lecture and a practical demonstration of mouth-to-mouth ventilation , ETI , and six SAD . Afterwards , the laypersons performed mouth-to-mouth ventilation and used each of the seven airway-management systems on an advanced patient simulator ( SimMan ) in a r and om sequence . All participants were re-evaluated 3 months later without any further practical or theoretical demonstration . Results The success rates for ETI were 74 % during the first evaluation and 64 % during the second , whereas the success rate for all six SAD was 100 % during all application attempts . The success rate for mouth-to-mouth ventilation was 86 % initially and 84 % 3 months later . The time to adequate mouth-to-mouth ventilation was 15±13 s initially and 16±7 s subsequently . ETI  required 53±21 s during the initial evaluation and 44±16 s 3 months later . Conclusion A variety of SAD all proved to reliably secure airways quickly , even in the h and s of complete novices . The SAD were much more effective than ETI , which often failed , and were even superior to mouth-to-mouth ventilation . SAD may thus be an appropriate first-line approach to field ventilation The aim of this study was to investigate whether briefly trained paramedics would be able to successfully intubate by endotracheal intubation ( ETI )  and using the laryngeal mask airway ( LMA ) and the I-gel in a manikin model . After the completion of a question naire , a brief educational session , and presentation of ETI , LMA , and I-gel , 72 paramedics were r and omly allocated to intubate an adult manikin . The success rate for I-gel was higher than that for LMA ( P<0.001 ) and ETI ( P<0.001 ) , and the insertion time for I-gel was significantly shorter than that for LMA ( P<0.001 ) or during ETI ( P<0.001 ) . There was a statistically significant association between the experience level of paramedics and insertion time only for the LMA ( P=0.012 ) . In addition , the mean insertion time values were significantly affected by the accuracy of the answers to the theoretical questions ( P<0.05 for all questions ) . Paramedics should lay greater emphasis on airway management using supraglottic devices , especially I-gel because of its shorter time of insertion INTRODUCTION This study was design ed to compare the performances of 4 airway devices in achieving successful ventilation . METHODS 
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However , a faster insertion time of the i-gel was not observed in comparisons with the LMA Supreme , aura-i , and air-Q. In addition , the i-gel did not show the better results for the insertion success rate when compared to other devices .
Conclusion : The findings of this meta- analysis indicated that inexperienced volunteers placed the i-gel more rapidly than other supraglottic airways with the exception of the LMA Supreme , aura-i , and air-Q in manikin studies .
However , the quicker insertion time is clinical ly not relevant .
The unapparent advantage regarding the insertion success rate and the inherent limitations of the simulation setting indicated that additional evidence is necessary to confirm these advantages of the i-gel in an emergency setting