Analysis of Battlefield Cricothyroidotomy in Iraq and Afghanistan

Robert L. Mary, MD; Alan Frankfurt, MD

The Journal of Special Operations Medicine

J Spec Oper Med. 2012 Spring;12(1):17-23.

#### Description with Key Points:

Historical review of modern military conflicts suggests that airway compromise accounts or 1-2 % of total combat fatalities. This study examines the specific intervention of pre-hospital cricothyrotomy (PC) in the military setting using the largest studies of civilian medics performing PC as historical controls.

#### Label

The majority of patients who underwent PC died (66%). The largest group of survivors had gunshot wounds to the face and/or neck (38%) followed by explosion related injury to the face, neck and head (33%). Military medics have a 33% failure rate when performing this procedure compared to 15% for physicians and physician assistants. Minor complications occurred in 21% of cases. The survival rate and complication rates are similar to previous civilian studies of medics performing PC. However, the failure rate for military medics is three to five times higher than comparable civilian studies.

Key Chart:
An Analysis of Battlefield Cricothyroidotomy in Iraq and Afghanistan
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## Take Home Message:

Military medics have a 33% failure rate when performing this procedure.
Historically, combat medics have often failed to get it right on the battlefield.
This is the most technically difficult procedure we ask medics, Corpsmen, and PJs to do.