Second generation SADs come highly recommended
Second generation devices, such as LMA® Protector™ Airway, come highly recommended in the recently published NAP4 audit conducted by the Royal College of Anaesthetists and the Difficult Airway Society, UK.
If tracheal intubation is not considered to be indicated but there is some (small) increased concern about regurgitation risk, a second generation supraglottic airway is a more logical choice than a first generation one.
In patients considered to be at low-risk of aspiration who have other factors that mean that use of a SAD is at the limits of normality (e.g. patient position, access to the airway, patient size) consideration should be given to use of a second generation SAD.
In view of the above recommendations, and the frequency of these circumstances, it is recommended that all hospitals have second generation SADs available for both routine use and rescue airway management.