Special Operations Forces Medical Handbook

7-25

Major airway

problem?

1. Position of comfort


2. Monitor


3. Nasopharyngeal airway

Withdraw or

remove tube

based on volume

of blood in lumen

Massive

hemoptysis?

1. Coma position


2. Chin lift or jaw thrust


3. Cricothyroidostomy

Attempt selective
intubation of right lung
first
99% chance of success

• Pass endotracheal
  tube through cords


• Advance until only
  adapter shows out
  mouth

YES

NO

NO

NO

YES

More blood

around than

through tube?

YES

Tube in less injured side

1. Secure tube in place


2. Assess need for ventilation


3. Auscultate for breath sounds

Pass endotracheal

tube through cords

to normal position

Tube in more injured

side

1. Auscultate for
   breath sounds


2. Use techniques for
   selective intubation of
   opposite side

Attemp selective intubation of

left lung

92% chance of success

• Turn casualty's head to right
  side


• Rotate tube 180° so curve of
  tube pointing to casualty's left
  side


• Advance until only adapter
  shows out mouth
  72% chance of success


• Do not turn casualty's head


• Rotate tube 90° counter-
  clockwise so curve of tube
  pointing to casualty's left side


• Advance until only adapter
  shows out mouth
  61% chance of success


• Do not turn casualty's head


• Rotate tube 180° so bevel on
  opposite side


• Advance until only adapter
  shows out mouth

More blood

around than

through tube?

NO

YES

Figure 7-5