Dispositifs supraglottiques:Pléthore ?

Review of Commercially Available Supraglottic Airway Devices for Prehospital Combat Casualty Care 

Copeland GB et Al. Military Medicine, Volume 187, Issue 7-8, July-August 2022, Pages e862–e876

 

Pour rappel ce type de dispositifs n'est pas recommandé en traumatologie du fait du risque de déplacement et d'inhalation et ce malgré une simplicité apparente d'emploi. De plus la diversité des ces dispositifs doit interpeller.

 

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Background

Airway obstruction is the second leading cause of potentially survivable death on the battlefield. The Committee on Tactical Combat Casualty Care lists airway optimization among the top 5 battlefield research and development priorities; however, studies show that combat medics lack access to the recommended supraglottic airway (SGA) devices. SGA devices are an alternative airway management technique to endotracheal tube intubation. Reports have shown SGA devices are easier to use and take fewer attempts to provide patent airflow to the patient when compared to endotracheal tube intubation. Military settings require a higher degree of skill to perform airway management on patients due to the environment, limited availability of equipment, and potential chaos of the battlefield. Finding the optimal SGA device for the military setting is an unmet need. The International Organization for Standardization describes basic functional requirements for SGA devices, as well as patient configurations and size limitations. Beyond that, no SGA device manufacturer states that their devices are intended for military settings.

Materials and Methods

We conducted a market review of 25 SGA devices that may meet inclusion into the medics’ aid bag. The company’s official “Instructions for Use” document, Google Scholar, and FDA reports were reviewed to obtain information for each SGA device.

Results

Twenty-five commercially available SGA devices are explored from manufacturer online sources. A commercially available device list is shown later in this paper, which provides the device’s features, indications, and contraindications based on the manufacturer’s product information documentation.

Conclusions

There are a variety of devices that require further testing to determine whether they should be included in sets, kits, and outfits.