Palmer Lee E
J Spec Oper Med. 2019 Spring;19(1):99-106. doi: 10.55460/KV13-RV6C.
Similar to people, airway obstruction is a potentially preventable cause of combat and line of duty death for civilian law enforcement Operational K9s (OpK9) and military working dogs (MWD). Basic (i.e., body positioning, manual maneuvers, bag-valve-mask ventilation) and advanced (i.e., endotracheal intubation, surgical airways) airway techniques are designed to establish a patent airway, oxygenate and ventilate, and protect from aspiration. A surgical airway (cricothyrotomy [CTT] or tracheostomy [TT]) is warranted for difficult airway scenarios in which less invasive means fail to open an airway (aka "Cannot intubate, cannot oxygenate"). In people, the surgical CTT is the preferred surgical airway procedure; most human prehospital providers are not even trained on the TT. Currently, only the TT is described in the veterinary literature as an emergent surgical airway for MWDs. This article describes the novel approach of instituting the surgical CTT for managing the canine difficult airway. The information provided is applicable to personnel operating within the US Special Operations Command as well as civilian tactical emergency medical services that may have the responsibility of providing medical care to an OpK9 or MWD.
与人类相似，气道梗阻是导致民用执法工作犬（OpK9）和军犬（MWD）在执行任务时死亡的一个潜在可预防原因。基础气道技术（即体位摆放、手法操作、袋阀面罩通气）和高级气道技术（即气管插管、外科气道）旨在建立通畅气道、进行给氧和通气以及防止误吸。在无创手段无法打开气道的困难气道情况下（即“无法插管、无法给氧”），需要进行外科气道（环甲膜切开术[CTT]或气管造口术[TT]）。在人类中，外科环甲膜切开术是首选的外科气道手术；大多数人类院前急救人员甚至未接受过气管造口术的培训。目前，兽医文献中仅将气管造口术描述为军犬的紧急外科气道。本文介绍了采用外科环甲膜切开术处理犬类困难气道的新方法。所提供的信息适用于在美国特种作战司令部内工作的人员以及可能负责为工作犬或军犬提供医疗护理的民用战术紧急医疗服务人员。
