Optimal Prehospital Practices for Airway Emergencies of Military Working Dog Combat Casualties.

Purpose: This study evaluated the feasibility of performing a surgical cricothyrotomy (CTT) in lieu of a tube tracheostomy (TT) as the first-line emergent surgical airway access technique in military working dogs (MWDs).

Methods: In a crossover, randomized trial, five emergency medicine physician residents (MD group), trained in performing CTT in people but not canines, and five early career veterinarians (DVM group), trained in performing TT in canines but not trained in performing CTT in canines, performed a CTT and TT on 10 canine cadavers.

Results: The time to complete CTT within the MD group was statistically shorter than the time to complete TT (P<.05). In the DVM group, the time to complete TT was shorter than that of CTT, but the time difference was not statistically significant (CTT: 239.6 [SD 251.7] s vs. TT: 133.4 [SD 88.0] s). In the MD group, the TT damage score was statistically higher than the CTT damage score (CTT: 0 vs. TT: 1.6 [SD 0.9], P<.01). There was no statistically significant difference between the damage scores of CTT and TT in the DVM group (CTT: 1.4 [SD 1.1] vs. TT: 1.6 [SD 0.9]). Overall, the participants reported a positive response with CTT compared to TT.

Conclusion: CTT is a viable first-line emergent surgical airway access technique when used by veterinarians and human healthcare clinicians with limited surgical experience or no proficiency in performing TT.