Wilderness Medical Society snowmass 2005 Page 281
5
Ranger AAR
1 wound infection in 14 casualties
Surgical Airway vs Intubation
Endotracheal Intubation on the Battlefield
No documentation of success
Often no actual intubation experience
White light on the battlefield
Obstruction typically caused by maxillofacial trauma
High potential for unrecognized esophageal intubations
Israeli Intubation Fatality
Night battlefield in Lebanon
Unconscious casualty in a combat action
Intubation attempted by Israeli physician
During the time that he had the white light on the laryngoscope turned on, shot in the head and
killed by a sniper
Picture of failed intubation casualty
What
Happened
This individual sustained a gunshot wound to the lower jaw that also injured the tongue and
upper airway structures. Attempted intubation in the field was unsuccessful. He died from airway
obstruction. His airway was intact at the cricothyroid membrane and below but no cric done.
What Might Have Saved Him
Proper airway positioning
of the casualty or
Surgical Airway
Nasopharyngeal airway
IV vs IM analgesia
5 mg IV
Onset of analgesia several minutes IV
