What Are Supraglottic Airways?

Supraglottic airway devices (SADs) are medical instruments inserted into the pharynx to maintain an open airway without the need for endotracheal intubation. They sit above the glottis — hence the name — and are widely used across emergency medicine, anaesthesia, and pre-hospital care throughout the UK.

Whether you're an anaesthetist in a busy NHS theatre, a paramedic responding to a cardiac arrest, or a theatre nurse preparing an airway trolley, understanding the differences between supraglottic airway devices is essential for patient safety and clinical outcomes.

Types of Supraglottic Airway Devices

1. i-gel (Intersurgical)

The i-gel is one of the most widely used supraglottic airways in the UK, particularly in pre-hospital and emergency settings. Its non-inflatable, gel-like cuff moulds to the perilaryngeal anatomy, providing a reliable seal without the need for cuff inflation.

Key features:

• Non-inflatable soft gel cuff — no syringe required
• Integrated bite block
• Gastric channel for suction or tube passage
• Available in sizes 1–5 (neonatal to large adult)
• Widely used by UK ambulance services and HEMS teams

Best for: Emergency airway management, cardiac arrest, short surgical procedures, difficult airway scenarios.

2. i-gel Plus (Intersurgical)

The i-gel Plus is the next generation of the i-gel, featuring an integrated cuff pressure indicator and an enhanced gastric channel. It maintains all the benefits of the original i-gel while offering improved monitoring capability.

Key features:

• Integrated cuff pressure indicator
• Enhanced gastric access channel
• Colour-coded by size for rapid identification
• Compatible with standard anaesthetic circuits

3. Laryngeal Mask Airway (LMA)

The LMA was the original supraglottic airway device, developed by Dr Archie Brain in the 1980s. It remains a cornerstone of airway management in UK anaesthetic practice.

Variants include:

• LMA Classic — reusable, inflatable cuff, suitable for routine anaesthesia
• LMA Unique — single-use version of the Classic
• LMA ProSeal — higher seal pressure, gastric drain tube, ideal for laparoscopic procedures
• LMA Supreme — single-use, reinforced airway tube, integrated bite block and gastric channel
• LMA Fastrach (iLMA) — designed for intubation through the device in difficult airway scenarios

4. IGEL vs LMA: Which Should You Choose?

Both devices are effective, but the choice depends on clinical context:

• i-gel — preferred in emergency/pre-hospital settings due to ease of insertion and no cuff inflation required
• LMA ProSeal/Supreme — preferred for longer surgical procedures requiring higher seal pressures
• LMA Fastrach — preferred when intubation through the SAD may be required

Frequently Asked Questions About Supraglottic Airways

What is the difference between a supraglottic and infraglottic airway?

A supraglottic airway sits above the vocal cords (glottis) and does not enter the trachea. An infraglottic airway, such as an endotracheal tube (ETT), passes through the vocal cords into the trachea. Supraglottic airways are generally easier and faster to insert, making them valuable in emergency situations.

Are supraglottic airways safe for all patients?

SADs are contraindicated in patients at high risk of aspiration (e.g. full stomach, hiatus hernia, morbid obesity) unless a second-generation device with a gastric channel (such as the i-gel or LMA ProSeal) is used. Always follow your trust's airway management guidelines.

Can supraglottic airways be used during CPR?

Yes. The Resuscitation Council UK guidelines support the use of supraglottic airways — particularly the i-gel — as an alternative to endotracheal intubation during CPR when performed by appropriately trained clinicians.

What sizes are available for paediatric patients?

Most supraglottic airways are available in paediatric sizes. The i-gel, for example, comes in sizes 1 (neonatal, 2–5 kg) through to size 5 (large adult, >90 kg). Always refer to the manufacturer's sizing guide based on patient weight.

How do I store and prepare supraglottic airways?

Single-use devices should be stored in their original sterile packaging in a cool, dry environment away from direct sunlight. Check the expiry date before use. Reusable devices must be decontaminated and sterilised according to your trust's infection control policy and the manufacturer's instructions.

Supraglottic Airway Accessories

For optimal airway management, consider stocking the following alongside your SADs:

• Lubricating gel — water-soluble, for ease of insertion
• Bite blocks — to prevent occlusion (many SADs have integrated bite blocks)
• Catheter mounts and HME filters — for connection to anaesthetic circuits
• Suction catheters — for use through the gastric channel
• Capnography equipment — to confirm correct placement and monitor ventilation

Buying Supraglottic Airways in the UK

At Medistock Medical Supplies, we stock a comprehensive range of supraglottic airway devices for NHS trusts, private hospitals, GP practices, and pre-hospital providers across the UK. Our range includes the i-gel, i-gel Plus, and a full selection of LMA variants — all sourced from trusted manufacturers and available for fast UK delivery.

We understand the clinical demands placed on airway practitioners, which is why we offer competitive pricing, bulk order discounts, and dedicated account management for healthcare organisations.

Browse our full supraglottic airway range →

Summary

Supraglottic airway devices are an essential component of modern airway management in the UK. From the versatile i-gel to the established LMA family, choosing the right device depends on your clinical setting, patient factors, and procedural requirements. Keeping your airway trolley stocked with the right SADs — and the accessories to support them — is fundamental to safe, effective patient care.

For expert advice on selecting the right supraglottic airway devices for your department or service, contact the Medistock team today.