Prehospital airway procedures performed in trauma patients by ground forces in Afghanistan

Blackburn, Megan B; April, Michael D.; Brown, D L; Lorenzo, Robert A. De; Ryan, Kathy L.; Blackburn, August; Schauer, Steven G

doi:10.1097/ta.0000000000001866

Cited by 25 publications

(11 citation statements)

References 14 publications

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“…Supplementary Table S1 details the findings of each included study; the quality of evidence findings are available in Supplementary Table S2 . 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 56 , 57 , 58 , 59 , 60 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 Thirty-three studies were low quality and 36 were very low quality. …”

Section: Resultsmentioning

confidence: 99%

“…55 Particularly in the military studies, the training behind the medical team performing FONA is not always clear as they are referred to as ‘combat medics’ or ‘military medics’. 26 , 30 , 52 , 56 , 57 , 58 , 59 , 60 There are also differences worldwide in the setup of prehospital teams and the standard FONA technique used; the 2017 guidelines were based on the UK DAS guidelines and may therefore not have been utilised outside of the UK. 5 , 61 There is also difficulty in extracting success rates before and after 2017 in datasets that overlap this time period with different techniques still being used despite the update in guidance.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Success rate of prehospital emergency front-of-neck access (FONA): a systematic review and meta-analysis

Morton

Avery

Kua

et al. 2023

British Journal of Anaesthesia

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Success rate of prehospital emergency front-of-neck access (FONA): a systematic review and meta-analysis

Morton

Avery

Kua

et al. 2023

British Journal of Anaesthesia

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“…Our model was based on factors that have been previously linked to poor outcomes (e.g. airway interventions) and the need for airway interventions as ketamine is frequently used as a sedative agent during rapid sequence intubation [16,17]. Significant variables were reported as odds ratios with 95% confidence intervals (OR, 95% CI).…”

Section: Discussionmentioning

confidence: 99%

Ketamine Administration in Prehospital Combat Injured Patients With Traumatic Brain Injury: A 10-Year Report of Survival

Torres¹,

Bebarta²,

April³

et al. 2020

Cureus

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Background The Tactical Combat Casualty Care (TCCC) guidelines recommend ketamine as the primary battlefield analgesic in the setting of moderate-to-severe pain and hemodynamic compromise. However, despite recent studies failing to support the association between ketamine and worse outcomes in head trauma, TCCC guidelines state that ketamine may worsen severe traumatic brain injury. We compared mortality outcomes following head trauma sustained in a combat setting between ketamine recipients and non-recipients. Methods This is a secondary analysis of previously published data in the Department of Defense Trauma Registry from January 2007 to August 2016. We isolated patients with an abbreviated injury scale of 3 or greater for the head body region. We compared mortality between prehospital ketamine recipients and non-recipients.

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“…4,5 Blackburn, et al reported that prehospital endotracheal intubation was performed in 68% of patients that received an airway intervention in the prehospital combat setting, with nearly 25% having a combat medic as the highest level of provider recorded in the patient record. 6 Clearing the airway is vital to airway management, as battlefield injuries can leave the airway clogged with blood, vomit, mucus, foreign bodies, and debris. 7 Airway suction, the act of using negative pressure in a patient's upper airway, removes debris that can prevent respiration, decreases possible aspiration risks, and allows clearer viewing of the airway for intubation.…”

Section: Introductionmentioning

confidence: 99%

A Market Review of Available Airway Suction Technology

Johnson

Lauby

Hood

et al. 2022

Prehosp. Disaster med.

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Introduction: Airway injuries are the second leading cause of potentially survivable battlefield death and often require airway management strategies. Airway suction, the act of using negative pressure in a patient’s upper airway, removes debris that can prevent respiration, decreases possible aspiration risks, and allows clearer viewing of the airway for intubation. The most important characteristics for a portable airway suction device for prehospital combat care are portability, strong suction, and ease of use. Methods: This market review searched academic papers, military publications, Google searches, and Amazon to identify devices. The search included specific characteristics that would increase the likelihood that the devices would be suitable for battlefield use including weight, size, battery life, noise emission, canister size, tubing, and suction power. Results: Sixty portable airway suction devices were resulted, 31 of which met inclusion criteria – 11 manually powered devices and 20 battery-operated devices. One type of manual suction pump was a bag-like design with a squeezable suction pump that was extremely lightweight but had limited suction capabilities (vacuum pressure of 100mmHg). Another type of manual suction pump had a trigger-like design which is pulled back to create suction with a firm collection canister that had increased suction capabilities (vacuum pressures of 188-600mmHg), though still less than the battery operated, and was slightly heavier (0.23-0.458kg). Battery-operated devices had increased suction capabilities and were easier to use, but they were larger and weighed more (1.18-11.0kg). Conclusion: Future research should work to lighten and debulk battery-operated suction devices with high suction performance.

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Prehospital airway procedures performed in trauma patients by ground forces in Afghanistan

Abstract: Prognostic and epidemiological study, level III.

Cited by 25 publications

References 14 publications

Success rate of prehospital emergency front-of-neck access (FONA): a systematic review and meta-analysis

Success rate of prehospital emergency front-of-neck access (FONA): a systematic review and meta-analysis

Ketamine Administration in Prehospital Combat Injured Patients With Traumatic Brain Injury: A 10-Year Report of Survival

A Market Review of Available Airway Suction Technology

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