Operational Consideration for Definitive Airway Management in the Austere Setting: A Case Report

• Published in: Journal of special operations medicine Vol. 22; no. 3; p. 90
• Main Authors: Morvan, Jean-Baptiste, Cotte, Jean, des Deserts, Marc Danguy, Worlton, Tamara, Menini, William, Cathelinaud, Olivier, Pasquier, Pierre
• Format: Journal Article
• Language: English
• Published: United States 19-09-2022
• Subjects: Airway Management; Airway Obstruction - surgery; Airway Obstruction - therapy; Emergency Medical Services; Humans; Intubation, Intratracheal; Mass Casualty Incidents; Tactical Combat Casualty Care; mass casualties; medical evacuation; airway; cricothyrotomy
• ISSN: 1553-9768
• DOI: 10.55460/WNNO-WIUG

In modern and asymmetric conflicts, traumatic airway obstruction caused by penetrating injury to the face and neck anatomy is the second leading cause of preventable mortality. Definitive airway management in the emergency setting is most commonly accomplished by endotracheal intubation. When this fails or is not possible, a surgical airway, usually cricothyrotomy, is indicated. The clinical choice for establishing a definitive airway in the austere setting is impacted by operational factors such as a mass casualty incident or availability and type of casualty evacuation. This is a case report of a patient with severe cervicofacial injuries with imminent airway compromise in the setting of a mass casualty incident, without possibility of sedation and mechanical ventilation during his evacuation. The authors seek to highlight the considerations and lessons learned for emergency cricothyrotomy.