TEXAS UNIV MEDICAL SCHOOL AT SAN ANTONIO SAN ANTONIO United States
Suction is a critical component of airway management, which is the second leading cause of preventable battlefield death. Current commercially available portable suction devices have not been scientifically validated for key performance measures relevant to prehospital care, let alone tactical combat casualty care. Current portable suction devices are not endorsed for combat casualty care and are considered too large and heavy to carry onto the battlefield anyway. As a result, the performance of suction itself is subsequently omitted as a care practice under current tactical combat casualty care TCCC treatment guidelines. It can be presumed that if a small, lightweight and effective device were available, the guidelines would change to reflect it. There are commercially available manual and powered suction devices on the market, and several are specifically advertised for use in prehospital tactical or combat environments. However, a review of the manufacturers information, user reviews, and the limited literature on performance, combine to suggest that no device on the market meets even the most basic requirements of being small, lightweight, rugged, and demonstrating adequate suction performance. This report synthesizes the available information and proposes a series of findings and recommendations to improved airway management in the prehospital combat environment. The key findings and recommendations are listed in the appendices along with the complete list of observations and recommendations. The net result should be the establishment of a military program to establish clinically- and militarily-relevant standards for suction devices used in prehospital and combat casualty care environments. The device specifications outlined in this report should be adopted as a starting point for the development and engineering of a future prehospital combat suction device.