i-Gel Survey
Name: 


  1. Enter the Alarm Number


  1. Enter the Date of the call


  1. This was a Arrest


  1. The iGel was used during a


  1. If this was a trauma, was a C Collar in place?
    Yes
    No
    Not a Trauma patient


  1. Was intubation attempted?
    Yes
    No


  1. If so, how many intubation attempts were made? 


  1. Was the bougie used to assist intubation attempt?
    Yes
    No


  1. What complications or difficulties were encountered with intubation attempts?


  1. Was the i-Gel used?
    Yes
    No


  1. What size i-Gel was used?


  1. Was the i-Gel successfully placed?
    Yes
    No


  1. What was the ETCO2 reading?


  1. What complications or difficulties were encountered with the i-Gel? (Be as specific as possible)


  1. Enter the Unit you were on





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