Advanced Airwaymanagement In Combat Casualties By Medics At The Point Of Injury: A Sub-Group Analysis Of The Reach Study

Mabry, Robert; Frankfurt, Alan

doi:10.55460/w35f-54hg

Cited by 30 publications

(12 citation statements)

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“…23 A recent review of airway management in 20 patients by medics at the point of injury showed that the most frequently used intervention was placement of an esophageal-tracheal airway. 21 Three (15%) service members in their study underwent a surgical cricothyrotomy. In 2 separate analyses of battlefield cricothyrotomy in Iraq and Afghanistan from military trauma databases, the procedure was documented as successful in 67% and 68% of the cases, a similar figure to our study (75% success rate).…”

Section: Discussionmentioning

confidence: 98%

“…A recent review of airway management in 20 patients by medics at the point of injury showed that the most frequently used intervention was placement of an esophageal‐tracheal airway 21 . Three (15%) service members in their study underwent a surgical cricothyrotomy.…”

Section: Discussionmentioning

confidence: 99%

“…19 In cases of disrupted airway anatomy, endotracheal intubation may not be the optimal choice for airway stabilization since it can lead to further destabilization. [20][21][22] Likewise, in austere conditions where intubation would most likely occur without the presence of sedation or in the setting of massive In multiple logistic regression, ORs were adjusted for facial fracture, injury severity, and mechanism of injury.…”

Section: Discussionmentioning

confidence: 99%

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Airway Management in Severe Combat Maxillofacial Trauma

Keller

Han

Galarneau

et al. 2015

Otolaryngol.--head neck surg.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Airway Management in Severe Combat Maxillofacial Trauma

Keller

Han

Galarneau

et al. 2015

Otolaryngol.--head neck surg.

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“…11,12 The alternative approach of cricothyrotomy represents only 5.8% of interventions, but comes with an overall failure rate of 28% to 33% and a 64% complication rate. [11][12][13][14][15][16] Supraglottic airways (SGAs) are an alternative that may be easier to insert, but they are not a definitive airway and may deliver suboptimal ventilation and incomplete protection from aspiration. 17 After-action reports from prehospital advanced airway management in combat environments found that 50% of failed attempts were attributable to equipment shortages or malfunctions while an additional 38% were secondary to a lack of training.…”

Section: Introductionmentioning

confidence: 99%

The Difficult Airway Redefined

Burgess

Schauer

Hood

et al. 2022

Prehosp. Disaster med.

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There is no all-encompassing or universally accepted definition of the difficult airway, and it has traditionally been approached as a problem chiefly rooted in anesthesiology. However, with airway obstruction reported as the second leading cause of mortality on the battlefield and first-pass success (FPS) rates for out-of-hospital endotracheal intubation (ETI) as low as 46.4%, the need to better understand the difficult airway in the context of the prehospital setting is clear. In this review, we seek to redefine the concept of the “difficult airway” so that future research can target solutions better tailored for prehospital, and more specifically, combat casualty care. Contrasting the most common definitions, which narrow the scope of practice to physicians and a handful of interventions, we propose that the difficult airway is simply one that cannot be quickly obtained. This implies that it is a situation arrived at through a multitude of factors, namely the Patient, Operator, Setting, and Technology (POST), but also more importantly, the interplay between these elements. Using this amended definition and approach to the difficult to manage airway, we outline a target-specific approach to new research questions rooted in this system-based approach to better address the difficult airway in the prehospital and combat casualty care settings.

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“…Some of the earliest simulators produced were for testing patient safety under anaesthesia by allowing reproduction of high-risk situations without risk to human subjects, similar in concept to training pilots. There are now simulators of various fidelity used for training prehospital providers [11], testing prototype devices and technologies [12], and assessing provider capabilities [13,14]. Given such extensive use, it is imperative that findings be put into context and manikins be verified as fit for purpose.…”

Section: Introductionmentioning

confidence: 99%

Anatomic accuracy of airway training manikins compared with humans*

et al. 2020

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Summary Airway simulators, or training manikins, are frequently used in research studies for device development and training purposes. This study was designed to determine the anatomic accuracy of the most frequently used low‐fidelity airway training manikins. Computerised tomography scans and ruler measurements were taken of the SynDaver®, Laerdal® and AirSim® manikins. These measurements were compared with human computerised tomography (CT) scans (n = 33) from patients at the University of Michigan Medical Center or previously published values. Manikin measurements were scored as a percentile among the distribution of the same measurements in the human population and 10 out of 27 manikin measurements (nine measurements each in three manikins) were outside of two standard deviations from the mean in the participants. All three manikins were visually identifiable as outliers when plotting the first two dimensions from multidimensional scaling. In particular, the airway space between the epiglottis and posterior pharyngeal wall, through which airway devices must pass, was too large in all three manikins. SynDaver, Laerdal and AirSim manikins do not have anatomically correct static dimensions in relation to humans and these inaccuracies may lead to imprecise airway device development, negatively affect training and cause over‐confidence in users.

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Advanced Airwaymanagement In Combat Casualties By Medics At The Point Of Injury: A Sub-Group Analysis Of The Reach Study

Cited by 30 publications

References 0 publications

Airway Management in Severe Combat Maxillofacial Trauma

Airway Management in Severe Combat Maxillofacial Trauma

The Difficult Airway Redefined

Anatomic accuracy of airway training manikins compared with humans*

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