SummaryWe studied the i-gel TM in 100 elective, anaesthetised patients (55 : 45 male:female, median age 53 years) assessing: ease of use, airway quality, positioning, seal and complications. First insertion attempt was successful in 86 patients, second attempt in 11 patients, and third attempt in three patients. Fifty three manipulations were required in 26 patients (median 1) to achieve a clear airway. Median insertion time was 15 s. During ventilation, expired tidal volume of 7 ml.kg )1 was achieved in 96 (96%) patients. Median airway leak pressure was 24 cmH 2 O. On fibreoptic examination via the device, vocal cords were visible in 87 patients (91%). During maintenance, six patients (6%) required 12 airway manipulations. There was one episode of regurgitation, without aspiration. Other complications and patient side-effects were mild and few. The i-gel is easily and rapidly inserted, providing a reliable airway in over 90% of cases. Further studies are indicated to assess safety and performance compared to other supraglottic airway devices.

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Videolaryngoscopy is available in most hospitals' main operating departments, but in fewer than half of other locations. There is marked variation in device, methods of introduction, usage, and clinical adoption. Most hospitals need to change practice to comply with current guidelines. Selection and implementation vary widely.

Intensive care medicine is 60 years old: the history and future of the intensive care unit Intensive care is celebrating its 60th anniversary this year. The concept arose from the devastating Copenhagen polio epidemic of 1952, which resulted in hundreds of victims experiencing respiratory and bulbar failure. Over 300 patients required artifi cial ventilation for several weeks. This was provided by 1,000 medical and dental students who were employed to hand ventilate the lungs of these patients via tracheostomies. By 1953, Bjorn Ibsen, the anaesthetist who had suggested that positive pressure ventilation should be the treatment of choice during the epidemic, had set up the fi rst intensive care unit (ICU) in Europe, gathering together physicians and physiologists to manage sick patients -many would consider him to be the 'father' of intensive care. Here, we discuss the events surrounding the 1952 polio epidemic, the subsequent development of ICUs throughout the UK, the changes that have occurred in intensive care over the past 10 years and what the future holds for the specialty.