The success of battlefield surgical airway insertion in severely injured military patients: a UK perspective

Kyle, Tony, le Clerc, S, Thomas, A, Greaves, I, Whittaker, V and Smith, J E (2016) The success of battlefield surgical airway insertion in severely injured military patients: a UK perspective. BMJ Military Health, 162 (6). ISSN 2633-3767

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Abstract

Background The insertion of a surgical airway in the presence of severe airway compromise is an uncommon occurrence in everyday civilian practice. In conflict, the requirement for insertion of a surgical airway is more common. Recent military operations in Afghanistan resulted in large numbers of severely injured patients, and a significant proportion required definitive airway management through the insertion of a surgical airway.

Objective To examine the procedural success and survival rate to discharge from a military hospital over an 8-year period.

Methods A retrospective database and chart review was conducted, using the UK Joint Theatre Trauma Registry and the Central Health Records Library. Patients who underwent surgical airway insertion by UK medical personnel from 2006 to 2014 were included. Procedural success, demographics, Injury Severity Score, practitioner experience and patient survival data were collected. Descriptive statistics were used for data comparison, and statistical significance was defined as p<0.05.

Results 86 patients met the inclusion criterion and were included in the final analysis. The mean patient age was 25 years, (SD 5), with a median ISS of 62.5 (IQR 42). 79 (92%) of all surgical airways were successfully inserted. 7 (8%) were either inserted incorrectly or failed to perform adequately. 80 (93%) of these procedures were performed either by combat medical technicians or General Duties Medical Officers (GDMOs) at the point of wounding or Role 1. 6 (7%) were performed by the Medical Emergency Response Team. 21 (24%) patients survived to hospital discharge.

Discussion Surgical airways can be successfully performed in the most hostile of environments with high success rates by combat medical technicians and GDMOs. These results compare favourably with US military data published from the same conflict.

Item Type: Article
Divisions: Faculty of Health Sciences and Wellbeing > School of Nursing and Health Sciences
Related URLs:
Depositing User: Tony Kyle
Date Deposited: 01 Feb 2021 11:55
Last Modified: 01 Feb 2021 11:55
URI: http://sure.sunderland.ac.uk/id/eprint/13095

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