RT Book, Section
A1 Helm, Matthias
A1 Vlatten, Arnim
A2 Hung, Orlando R.
A2 Murphy, Michael F.
SR Print(0)
ID 1146619936
T1 Airway Management Under Combat Conditions
T2 Hung's Difficult and Failed Airway Management, 3e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259640544
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1146619936
RD 2024/04/18
AB A  unit  of  a  14-person,  six-vehicle  military  convoy  is  moving  through  a  village  in  northern  Afghanistan.  As  the  convoy  pulls  out  on  open  road  at  the  end  of  that  village,  an  improvised  explosive  device  (IED)  discharges  under  the  second  vehicle  manned  with  two  soldiers.  Intensive  sniper  fire  follows  and  the  rest  of  the  convoy  is  busily  engaged  in  suppressing  it.  The  non-armored  disabled  vehicle  is  right  side  up  and  not  on  fire.  You  are  the  medic  of  the  unit  and  you  are  in  an  armored  vehicle,  next  to  the  demolished  vehicle  with  the  two  victims.  As  you  arrive  at  the  vehicle,  you  find  two  casualties:  Casualty  #1  is  the  driver  of  the  vehicle.  He  sustained  bilateral  mid-thigh  traumatic  amputations,  as  well  as  a  penetrating  injury  of  the  pelvis  and  the  abdomen.  Furthermore,  there  is  a  large  open  head  wound  in  which  mangled  gray  matter  is  clearly  visible.  There  are  no  vital  signs—he  is  obviously  dead.  Casualty  #2  is  the  front-seat  passenger.  He  sustained  a  below-knee  amputation  of  his  left  leg  with  heavy  arterial  bleeding  from  the  stump,  as  well  as  multiple  injuries  to  the  left  side  of  his  face.  He  has  significant  soft-tissue  trauma,  and  has  sustained  a  visible  comminuted  fracture  of  the  mandible.  You  note  moderate  bleeding  from  the  left  facial  injury.  The  soldier  is  conscious  and  has  a  good  radial  pulse  but  the  airway  appears  compromised  due  to  disrupted  airway  anatomy  (maxillofacial  trauma)  and  bleeding  into  the  airway.