Rich James M, Thierbach Andreas, Frass Michael
Department of Anesthesiology and Pain Management, Baylor University Medical Center, Dallas, Texas 75246, USA.
Mil Med. 2006 May;171(5):389-95. doi: 10.7205/milmed.171.5.389.
Combat lifesavers and Army medics are regular combat soldiers who possess skills that enable them to provide lifesaving assistance to combat casualties. Although their training is not equal to that of paramedics, combat lifesavers and Army medics are trained to assess casualties for airway obstruction, as well as the presence or absence of spontaneous ventilation. They are also familiar with the same basic airway maneuvers that are required for blind insertion of the esophageal-tracheal double-lumen airway (ETDLA). Use of the ETDLA in combination with an esophageal detector device and a colorimetric carbon dioxide detector would require skill similar to that which they already possess in performing many mission-essential and combat lifesaver tasks. Because the U.S. Army has introduced the ETDLA for use, it is important that providers at all echelons understand the dynamics of the ETDLA. Inclusion of the ETDLA, esophageal detector device, and colorimetric carbon dioxide detector in combination with the bag-valve ventilation device could provide a viable alternative to mouth-to-mouth rescue breathing with the oral airway, as currently used by combat lifesavers on the battlefield. Improved airway management, in conjunction with other lifesaving measures, could potentially improve survival rates for combat casualties and assist in stabilizing them for evacuation to higher echelons of combat medical care.
战斗救生员和陆军医护兵是普通战斗士兵，他们具备为战斗伤员提供救生援助的技能。尽管他们的训练与护理人员不同，但战斗救生员和陆军医护兵接受过评估伤员气道阻塞情况以及是否存在自主呼吸的训练。他们也熟悉盲插食管气管双腔气道（ETDLA）所需的基本气道操作。将ETDLA与食管探测器和比色二氧化碳探测器结合使用，所需技能与他们在执行许多任务关键和战斗救生任务中已具备的技能相似。由于美国陆军已引入ETDLA供使用，各级医疗人员了解ETDLA的工作原理非常重要。将ETDLA、食管探测器和比色二氧化碳探测器与袋阀通气装置结合使用，可为战斗救生员目前在战场上使用的通过口咽气道进行口对口抢救呼吸提供可行的替代方案。改善气道管理，结合其他救生措施，可能会提高战斗伤员的存活率，并有助于使其稳定以便后送至更高层级的战斗医疗护理机构。
