Registry of Emergency Airways Arriving at Combat Hospitals

Abstract

Under combat conditions, the overall rate of correctly placed ETTs performed by military prehospital providers was comparable with that of published U.S. civilian paramedic data.

Advanced Airway Management – a Medical Emergency Response Team Perspective

“…those transferred postoperatively from an FST location rather than direct from the point of wounding, are excluded. The majority of the cases were trauma (93.5%) with the remaining non-trauma causes (6.5%) ( Table 1); this figure is again similar to the recent US study [11].…”

“…The standard military pre-hospital team does not have the means of measuring some of these variables and therefore a great reliance is placed on clinical judgment. [11] Using these criteria the subsequent analysis of patients arriving at a single CSH identified a further 4.7% of patients who the investigators felt should ideally have undergone pre-hospital airway management [11]. This figure is similar to the further 5.8% of patients in our study who were identified by the MERT as requiring advanced airway management prior to hospital arrival.…”

“…The proportions of airway techniques undertaken can be compared to the Adams et al study [11]. The most common technique in both studies was oral endotracheal intubation, this was followed by the use of oesophageal-tracheal airways in the Adams study, a technique used for only a single patient among our cohort.…”

“…Analysis of US data assembled during the Vietnam War by the Wound Data and Munitions Effectiveness Team (WDMET) demonstrates that between 5 and 10% of patients entering the medical system will require emergency airway management before reaching the combat support hospital (CSH) [10]. These historical figures do not seem, at first look, to be supported by a recent US study by Adams et al which demonstrated that 4.2% of a total of 6875 casualties arriving at CSHs required emergency advanced airway intervention [11].…”

Prehospital intubation success rates among Israel Defense Forces providers

“…In the military setting, the battlefield environment leads to very challenging conditions, although data suggest that success is on par with that seen in the civilian setting. 2 As part of Tactical Combat Casualty Care (TCCC), surgical cricothyroidotomy (CRIC) is taught to combat medics as the primary means for establishing a definitive airway in the field; supraglottic devices and ETI are additional options starting during the evacuation phase where more advanced providers are available. 3 In the Israel Defense Forces (IDF), our frontline ALS providers are trained to perform ETI and CRIC.…”