Operational Consideration for Definitive Airway Management in the Austere Setting A Case Report

In modern and asymmetric conflicts, traumatic airway ob-struction caused by penetrating injury to the face and neck anatomy is the second leading cause of preventable mortal-ity. Definitive airway management in the emergency setting is most commonly accomplished by endotracheal intubation. When this fails or is not possible, a surgical airway, usually cri-cothyrotomy, is indicated. The clinical choice for establishing a definitive airway in the austere setting is impacted by operational factors such as a mass casualty incident or availability and type of casualty evacuation. This is a case report of a patient with severe cervicofacial injuries with imminent airway compromise in the setting of a mass casualty incident, without possibility of sedation and mechanical ventilation during his evacuation. The authors seek to highlight the considerations and lessons learned for emergency cricothyrotomy.