Feasibility of supraglottic airway use by combat lifesavers on the modern battlefield

Abstract

Background: Airway compromise is a contributor to preventable mortality on the battlefield. Supraglottic airway devices are an accepted intervention for these casualties. Combat Medics, civilian prehospital care providers, and lay civilians have demonstrated proficiency with supraglottic airways. However, the Combat Lifesaver (CLS) course includes no instruction on their use. Objective: The purpose of this study was to assess feasibility of instructing CLS students to use a supraglottic airway (the King LT-D); compare their timed performance with that of Special Operations Combat Medics (SOCM); and assess their confidence utilizing the device. Methods: After standardized instruction, students were timed and evaluated in the placement of a King LT-D in a manikin. Student confidence was assessed by Likert-scaled surveys, and free response remarks collected before and after training. Results: 27 of 28 CLS students successfully used a King LT-D airway device in under 60 seconds following brief instruction. Placement times were not significantly different from those of SOCM. Self-rated confidence scores improved from an initial 1.4/5 to 4.9/5 following manikin trials. Both CLS and SOCM recommended the airway for future battlefield CLS use. Conclusions: CLS students are capable and confident in the use of a supraglottic airway device after only brief instruction. © Association of Military Surgeons of the U.S. All rights reserved.