Abstract

Airway clearance is a foremost priority for combat medics dealing with battlefield trauma. This life saving intervention starts with inspection, clearing any obstructions from the airway, and if necessary, placement of an endotracheal tube to secure the airway. For inspecting and clearing the airway under complicated battlefield conditions, combat medics require a portable suction device that is compact, lightweight, rugged, and capable of rapidly evacuating a mix of liquid and solid particles, which may include bone fragments or broken teeth. While several portable suction devices are available on the market, none were developed specifically for the combat environment. Interviews with combat medics and other relevant personnel revealed that currently available systems are limited in utility to the point of often being intentionally omitted from their kits. In addition, these discussions identified several design specifications for a desired system, such as size (30 × 10 × 10 cm), weight (≤1 kg), fluid flowrate (1 L/min), and canister size (0.5–1 L), among others. This research focused on developing and characterizing a functional prototype within the specified design criteria. After designing and fabricating the device, evacuation of water, blood mimicking solution, and simulated vomitus solution were assessed. In addition, a comparative analysis was carried out between the five different commercially available suction catheters by assessing fluid flow rate and obstruction resistance. The results demonstrate the first proof-of-concept characterization for a novel combat-oriented suction system and provide a basis for comparing the performance of suction systems and catheters used in airway management.

References

1.
Eastridge
,
B. J.
,
Mabry
,
R. L.
,
Seguin
,
P.
,
Cantrell
,
J.
,
Tops
,
T.
,
Uribe
,
P.
,
Mallett
,
O.
,
Zubko
,
T.
,
Oetjen-Gerdes
,
L.
,
Rasmussen
,
T. E.
,
Butler
,
F. K.
,
Kotwal
,
R. S.
,
Holcomb
,
J. B.
,
Wade
,
C.
,
Champion
,
H.
,
Lawnick
,
M.
,
Moores
,
L.
, and
Blackbourne
,
L. H.
,
2012
, “
Death on the Battlefield (2001-2011): Implications for the Future of Combat Casualty Care
,”
J. Trauma Acute Care Surg.
,
73
(
6 Suppl. 5
), pp.
S431
S437
.
2.
Peake
,
J. B.
,
2005
, “
Beyond the Purple Heart–Continuity of Care for the Wounded in Iraq
,”
N. Engl. J. Med.
,
352
(
3
), pp.
219
222
.
3.
Prokakis
,
C.
,
Koletsis
,
E. N.
,
Dedeilias
,
P.
,
Fligou
,
F.
,
Filos
,
K.
, and
Dougenis
,
D.
,
2014
, “
Airway Trauma: A Review on Epidemiology, Mechanisms of Injury, Diagnosis and Treatment
,”
J. Cardiothorac. Surg.
,
9
, p.
117
.
4.
Cloonan
,
C. C.
,
2003
, “
Don't Just Do Something, Stand There!”: To Teach or Not to Teach, That Is the Question–Intravenous Fluid Resuscitation Training for Combat Lifesavers
,”
J. Trauma
,
54
(
5 Suppl
.), pp.
S20
S25
.
5.
Calkins
,
M. D.
,
Reese
,
K.
,
Costello
,
M.
,
Mu
,
T.
, and
Bentley
,
T. B.
,
2002
, “
Evaluation of Possible Battlefield Suction Pumps for the Far-Forward Setting
,”
Mil. Med.
,
167
(
10
), pp.
803
809
.
6.
Adams
,
B. D.
,
Cuniowski
,
P. A.
,
Muck
,
A.
, and
De Lorenzo
,
R. A.
,
2008
, “
Registry of Emergency Airways Arriving at Combat Hospitals
,”
J. Trauma
,
64
(
6
), pp.
1548
1554
.
7.
De Lorenzo
,
R. A.
, and
Porter
,
R. S.
,
1999
,
Tactical Emergency Care, Brady
,
Prentice Hall
,
Upper Saddle River, NJ
.
8.
U.S. Army
,
2012
,
Tactical Combat Casualty Care: Lessons and Best Practices
,
Center for Army Lessons Learned
,
Fort Leavenworth, KS
.
9.
De Lorenzo
,
R. A.
,
Hood
,
R. L.
,
Jain
,
P.
,
Pescador
,
R.
,
Lasch
,
M.
, and
Feng
,
Y.
,
2017
, “
Summary of Findings and Recommendations for Suction Devices for Management of Prehospital Combat Casualty Care Injuries
,”
Defense Technical Information Center (DTIC)
,
Fort Belvoir, VA
.
10.
Committee on Tactical Combat Casualty Care (TCCC)
,
2017
,
Tactical Combat Casualty Care Guidelines for Medical Personnel
,
National Association of Emergency Medical Technicians (NAEMT)
,
Clinton, MS
.
11.
Arnstein
,
F. E.
,
1996
, “
A Practical Evaluation of Four Human-Powered Portable Airway Aspirators
,”
Anaesthesia
,
51
(
1
), pp.
63
68
.
12.
Simon
,
E. J.
,
Davidson
,
J. A.
, and
Boom
,
S. J.
,
1993
, “
Evaluation of Three Portable Suction Devices
,”
Anaesthesia
,
48
(
9
), pp.
807
809
.
13.
DuCanto
,
J.
,
Serrano
,
K. D.
, and
Thompson
,
R. J.
,
2017
, “
Novel Airway Training Tool That Simulates Vomiting: Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) System
,”
West. J. Emerg. Med.
,
18
(
1
), pp.
117
120
.
14.
ISO
,
2015
, “
Medical Suction Equipment—Part 1: Electrically Powered Suction Equipment
,”
International Organization for Standardization
,
Geneva, Switzerland
, Standard No. ISO 10079-1.
15.
Brook
,
A. H.
,
Griffin
,
R. C.
,
Townsend
,
G.
,
Levisianos
,
Y.
,
Russell
,
J.
, and
Smith
,
R. N.
,
2009
, “
Variability and Patterning in Permanent Tooth Size of Four Human Ethnic Groups
,”
Arch. Oral Biol.
,
54
(
Suppl. 1
), pp.
S79
S85
.
16.
Cheyne
,
V. D.
, and
Oba
,
J. T.
,
1943
, “
Average Weights of the Permanent Teeth, Including the Relative Amounts of Enamel to Dentin and Cementum
,”
J. Dent. Res.
,
22
(
3
), pp.
181
184
.
17.
Temptime
,
2012
, “
Simulated Blood Products: 10% Glycerol in Water may not be One Size Fits All
,”
Temptime Corporation
,
Morris Plains, NJ
.
You do not currently have access to this content.