I'm writing an article on Supraglottic Airway Devices (SAD's) in the Tactical Environment (to be published soon) and during the course of my research, I created a matrix much like the one I posted for hemostatic agents under the thread titled "TraumaDex".

I thought to myself, what kind of medic would I be if I didn't share this information with my fellow combat/tactical medics and brothers in arms, so not to take away from Stallion 13's thread on the King LT-D vs CombiTube, please find attached, my synopsis of alternative airway devices to include:

Name
Cost
Manufacture
Website
Description
Recommendations
Complications

Although recent studies show the King LT-D to be the "King" of the Hill (so-to-speak) and the fact that I completely endorse the product...I will say, I currently use the Rusch EasyTube (EzT) and have had for several years and with a great deal of success, AND will probably continue to use it only because I don't want to spend my beer money on another toy...Should I use my current SAD, then I will most likely purchase the King LT-D.

Also posted for your reading pleasure is an abstract titled "Supraglottic Devices in Tactical Airway Management: A Comparison of the King Laryngeal Tracheal Device and the Combitube in Army Combat Medic Students".

www.allacademic.com/me...index.html
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I hope you all benefit from this post and enjoy...My work here is done.

Thanks for the article brother, godd info.ciao

Thats a great looking pic.

Chase,

Great info and article on SAD's in a TE. Some new companies I have not heard of and I will check out their products. Thanks again for you enlighting post.

Doc

Thnaks Chase for such interesting info.

I would like to ask you (and anyone that could answer) a question about hthe airway management in the TCCC. What do they recomend nasopharyngel airway instead guedel airway. Which are the advantages?

Thanks again

The 2007 TCCC recommendations are posted on this forum under the heading TCCC 2007 update or you can refer to the CoTCCC recommendations...Personally, I prefer an NPA as it is less invasive and can be tolerated in the conscious adult without stimulating a gag reflex...OPA's serve their purpose, when there is no alternative airway choice, when advanced airways such as intubation are required, and the nature of the injury dictates an OPA, but are very limited in benefit and use

Chase,

I concur. An NPA is a better choice for the conscious PT. I do have a question though. Surgical Airways. Are contractors authorized to provide a surgical airway if there is Maxo-facial trauma that inhibits the use of a NPA/OPA? I know we train the AD guys how to do it and practice a little bit. I guess I want to get a feel for the contractors side of the house concerning the use of a Surgical Airway. Thanks

Doc

Doc_Pipe_Hitter wrote:

Chase, I concur. An NPA is a better choice for the conscious PT. I do have a question though. Surgical Airways. Are contractors authorized to provide a surgical airway if there is Maxo-facial trauma that inhibits the use of a NPA/OPA? I know we train the AD guys how to do it and practice a little bit. I guess I want to get a feel for the contractors side of the house concerning the use of a Surgical Airway. Thanks Doc

Doc,

Perhaps you should re-word the question to read; "Are medics contracted to provide combat/tactical emergency care authorized to use surgical airways in the presence of maxilo-facial trauma? The answer is yes, if they are certified advanced providers such as EMT-Intermediates, Paramedics and/or CCP's that are trained to do so.

Currently in the present theater of operations, there exists a very leanient scope of practice concerning contracted medics due to the wide array of TCN providers...Granted there is one solid standard of care worldwide, but only at the basic level.

Authorization would depend on your employer...Do they have written medical protocols, do they retain a physcian/medical director, do they require national registration at the minimum EMT-I level, do they have the appropriate equipment, and lastly, are their medics trained and tested in skills proficeincy/competency?

Just because someone claimes to be a Paramedic, does not a Paramedic make! I know several Paramedics who aren't competent enough to attempt any invasive procedures, let alone a surgical airway, but are working in that capacity here and now...On the same token, I know CLS providers that have done things in the military, whom I would trust my life with in their care.

When I was working as a PSD medic, we would on occassion have a client that would mention that they were also certified paramedics, but that alone does not give them the "authorization" to perform the procedure, although I doubt no one would complain if the circumstances dictated it, ie; medic down/KIA, etc, etc and the outcome was favorable, but heaven forbid, if that guy fucks up!

Some guys will say, "hey, ya gotta do what ya gotta do".