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SGAs may be used as primary airway management tools, or as rescue devices for failed ETI [51, 52]. SGAs are generally easier to insert and have greater success rates than surgical airway techniques, especially in situations potentially involving difficult airway anatomy. National consensus guidelines recommend that all EMS personnel carry at least one type of SGA (e.g., laryngeal tube, i‐gel, or Laryngeal Mask Airway™) for airway management in the event of failed ETI efforts [53].

The 2015 Advanced Cardiac Life Support guidelines emphasize the delivery of uninterupted chest compressions during CPR [54]. Embracing this principle, a growing number of EMS agencies have elected to substitute ETI with the rapid insertion of an SGA in patients suffering cardiopulmonary arrest [55, 56]. Benefits of using SGAs as the primary invasive airway device may include the simplicity of operation, the reduced risk of significant adverse events (such as inadvertent airway dislodgement), and the reduced baseline and skills maintenance burdens. Additionally, SGA insertion skills may be more easily translated from mannequin training to clinical application on live patients. Limited data verify the ablity of EMS personnel to place SGAs during cardiac arrest in less time than an endotracheal tube [13].

Some EMS agencies enable BLS clinicians to insert SGAs. Previous studies have demonstrated the use of SGAs in this group with a high degree of success [31, 57]. First‐pass success appears higher with SGA than ETI [12, 13]. BLS use of SGAs outside of cardiac arrest has not been studied.