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Airway Clearance Using Suction Devices in Prehospital Combat Casualty Care: A Systematic Review

Published online by Cambridge University Press:  10 September 2020

Priya Jain Open the ORCID record for Priya Jain [Opens in a new window] ,
Forhad Akhter ,
Austin Schoppe ,
R. Lyle Hood  and
Robert A. De Lorenzo
Priya Jain
Affiliation:
Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, Texas, USA Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, Texas, USA Graduate School of Biomedical Sciences, The University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
Forhad Akhter
Affiliation:
Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, Texas, USA
Austin Schoppe
Affiliation:
Department of Biomedical Engineering, The University of Texas at San Antonio, San Antonio, Texas, USA
R. Lyle Hood
Affiliation:
Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, Texas, USA Graduate School of Biomedical Sciences, The University of Texas Health Science Center San Antonio, San Antonio, Texas, USA Department of Emergency Medicine, The University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
Robert A. De Lorenzo*
Affiliation:
Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, Texas, USA Graduate School of Biomedical Sciences, The University of Texas Health Science Center San Antonio, San Antonio, Texas, USA Department of Emergency Medicine, The University of Texas Health Science Center San Antonio, San Antonio, Texas, USA
*
Correspondence: Robert A. De Lorenzo, MD, MSM, MSCI, FACEP, Department of Emergency Medicine, UT Health San Antonio (UTHSA), 7703 Floyd Curl Drive, Mail Code 7736, San Antonio, Texas78229-3900USA, E-mail: [email protected]
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Abstract

Airway management is at the forefront for combat medics dealing with battlefield trauma. For military service members, compromised airways are the second leading cause of potentially survivable death on the battlefield, accounting for one in ten preventable combat deaths. Effective suction is a critical component of airway clearance. However, currently available devices are too heavy and bulky to be carried by combat medics and are insufficiently powered. The industry has not responded to the need, with companies continuing to produce models using 1970s technology. A literature review was completed with the assistance of a librarian. The databases searched included: Biomedical Research Database (BRD), Computer Retrieval of Information of Scientific Projects (CRISP), Federal Research in Progress (FEDRIP), Defense Technical Information Center (DTIC), Pub Med/Medline, and OVID. Additionally, a Google Scholar search was performed to identify nonstandard sources. After screening, a total of 40 articles were used. There were no randomized controlled trials or other high-quality evidence that addressed the issues; there was limited peer-reviewed literature on the use, effectiveness, adverse effects, and safety of suction for use in combat casualty care. A review of the available literature revealed no standards, either proposed, validated, or accepted, for the safety or avoidance of adverse effects for portable suction device use in combat casualty care. Similarly, there are no accepted standards to guide the safe use and anticipated adverse effects of suction for use in prehospital combat or emergency care. Nevertheless, there are meaningful data that can be extracted from the few studies available combined with non-clinical studies, narrative reviews and case reports, and expert opinions.

Keywords

airway managementairway suction devicecombat medicoropharyngeal airway clearancesprehospital combat casualty care
Type
Systematic Review
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 6 , December 2020 , pp. 676 - 682
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Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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