A supra-glottic airway (SGA) provides improved airway and ventilation management compared to a
bag-valve-mask and OPA. It does not offer the same level of protection against aspiration as
intubation, however is it often quicker and easier to insert and may be an appropriate initial method
of managing the airway.

If an SGA is placed, the insertion of an orogastric tube may provide benefit in decompressing the
stomach and allowing drainage of gastric contents.

In the setting of cardiac arrest, insertion of an orogastric tube must not delay or interfere with higher
priority actions such as uninterrupted compressions or defibrillation.

Patients who require higher airway pressures e.g. pregnancy, morbid obesity, decreased pulmonary
compliance (pulmonary fibrosis) or increased airway resistance (severe asthma) should be carefully
monitored to ensure effective ventilation is being achieved and passive regurgitation avoided.

If an SGA is inserted, ventilation proves difficult or inadequate and trouble-shooting fails to correct
the issue, consider removing the SGA if ventilation is possible through another airway management
plan.

Three attempts in total at SGA insertion are permitted irrespective of skill-set (ALS, MICA, MFP). If
difficulty is encountered in the placement of an SGA, problem solving aimed at improving the chance
of success should occur prior to subsequent attempts.