Extraglottic Airways in Tactical Combat Casualty Care: TCCC Guidelines Change 17-01 28 August 2017

Area of Science:

• Emergency Medicine
• Trauma Care
• Airway Management

Background:

• Extraglottic airway (EGA) devices have been utilized for decades in prehospital and combat casualty care.
• Previous guidelines supported supraglottic airway (SGA) devices but did not specify a preferred device.
• The term extraglottic airway (EGA) is now preferred for inclusivity.

Purpose of the Study:

• To update the Tactical Combat Casualty Care (TCCC) guidelines regarding airway management.
• To recommend the i-gel as the preferred EGA due to its ease of use and safety features.
• To provide comprehensive guidance on adjuncts and considerations for airway management in tactical settings.

Main Methods:

• Review of current evidence on extraglottic airway devices.
• Inclusion of i-gel as the preferred EGA in TCCC guidelines.
• Integration of updated recommendations for airway adjuncts and monitoring.

Main Results:

• The i-gel demonstrates comparable or superior performance to other EGAs, with advantages in training, size, weight, cost, and simplicity.
• The i-gel's gel-filled cuff eliminates the need for cuff pressure monitoring and reduces the risk of nerve injury.
• Updated guidelines incorporate EGAs into Tactical Field Care, recommend i-gel, and detail its use alongside other airway management strategies.

Conclusions:

• The i-gel offers significant advantages for tactical airway management, simplifying procedures and enhancing patient safety.
• Updated TCCC guidelines provide a clear framework for utilizing EGAs and adjuncts effectively.
• Continuous reassessment of airway status is crucial for optimal casualty care.