Airway management is at the forefront for combat medics dealing with battlefield trauma. For military service members, compromised airways are the second leading cause of potentially survivable death on the battlefield, accounting for one in ten preventable combat deaths. Effective suction is a critical component of airway clearance. However, currently available devices are too heavy and bulky to be carried by combat medics and are insufficiently powered. The industry has not responded to the need, with companies continuing to produce models using 1970s technology. A literature review was completed with the assistance of a librarian. The databases searched included: Biomedical Research Database (BRD), Computer Retrieval of Information of Scientific Projects (CRISP), Federal Research in Progress (FEDRIP), Defense Technical Information Center (DTIC), Pub Med/Medline, and OVID. Additionally, a Google Scholar search was performed to identify nonstandard sources. After screening, a total of 40 articles were used. There were no randomized controlled trials or other high-quality evidence that addressed the issues; there was limited peer-reviewed literature on the use, effectiveness, adverse effects, and safety of suction for use in combat casualty care. A review of the available literature revealed no standards, either proposed, validated, or accepted, for the safety or avoidance of adverse effects for portable suction device use in combat casualty care. Similarly, there are no accepted standards to guide the safe use and anticipated adverse effects of suction for use in prehospital combat or emergency care. Nevertheless, there are meaningful data that can be extracted from the few studies available combined with non-clinical studies, narrative reviews and case reports, and expert opinions.

Airway clearance is a foremost priority for combat medics dealing with battlefield trauma. This life saving intervention starts with inspection, clearing any obstructions from the airway, and if necessary, placement of an endotracheal tube to secure the airway. For inspecting and clearing the airway under complicated battlefield conditions, combat medics require a portable suction device that is compact, lightweight, rugged, and capable of rapidly evacuating a mix of liquid and solid particles, which may include bone fragments or broken teeth. While several portable suction devices are available on the market, none were developed specifically for the combat environment. Interviews with combat medics and other relevant personnel revealed that currently available systems are limited in utility to the point of often being intentionally omitted from their kits. In addition, these discussions identified several design specifications for a desired system, such as size (30 × 10 × 10 cm), weight (≤1 kg), fluid flowrate (1 L/min), and canister size (0.5–1 L), among others. This research focused on developing and characterizing a functional prototype within the specified design criteria. After designing and fabricating the device, evacuation of water, blood mimicking solution, and simulated vomitus solution were assessed. In addition, a comparative analysis was carried out between the five different commercially available suction catheters by assessing fluid flow rate and obstruction resistance. The results demonstrate the first proof-of-concept characterization for a novel combat-oriented suction system and provide a basis for comparing the performance of suction systems and catheters used in airway management.

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