Enhancing military airway suction devices with a focus on performance and portability

Abstract Background Airway management is critical in combat casualty care, with airway compromise being the second leading cause of preventable battlefield deaths. Suction devices are essential for clearing obstructions during airway management; however, many medics choose not to carry them due to t...

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Main Authors: Maria J. Londono, Saketh R. Peri, Rakib Hasan, Connor J. Evans, David Restrepo, Robert A. De Lorenzo, R. Lyle Hood
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Emergency Medicine
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Online Access:https://doi.org/10.1186/s12873-025-01262-4
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author Maria J. Londono
Saketh R. Peri
Rakib Hasan
Connor J. Evans
David Restrepo
Robert A. De Lorenzo
R. Lyle Hood
author_facet Maria J. Londono
Saketh R. Peri
Rakib Hasan
Connor J. Evans
David Restrepo
Robert A. De Lorenzo
R. Lyle Hood
author_sort Maria J. Londono
collection DOAJ
description Abstract Background Airway management is critical in combat casualty care, with airway compromise being the second leading cause of preventable battlefield deaths. Suction devices are essential for clearing obstructions during airway management; however, many medics choose not to carry them due to their excessive weight. Current standards for suction devices mention a minimum liquid flow rate of 1.2 L/min and a maximum device weight of 6 kg, but these standards fail to meet the practical needs of military end-users. The team conducted an I-Corps funded end-user assessment study with over 100 participants, in which a minimum flow rate of 1 L/min and a maximum weight of 4.5 kg were indicated as preferred among respondents. This gap between the standards and user preferences results in exclusion of existing devices from military kits due to weight concerns despite meeting performance criteria. Methods To address this gap, the Suction Combat Ready Advanced Multifunctional Machine (SCRAMM) was developed with input from U.S. Military clinical stakeholders to emphasize both performance and portability. SCRAMM is designed to handle diverse medical scenarios simultaneously and was characterized against the market leaders Zoll 330 and Impact 326M. Liquid flow rates and device weights were measured and analyzed according to ISO standards and end-user requirements. Results Zoll 330 and Impact 326M exceeded the ISO-required liquid flow rate by 145%, with weights of 4.8 kg and 5.1 kg, respectively. Additionally, both devices were heavier than the user-preferred weight limit of 4.5 kg. SCRAMM, with three suction lines for simultaneous diverse medical tasks, exceeded the ISO flow rate by 23%. It remained within the preferred weight range at 3.4 kg, demonstrating greater performance-to-weight balance in consideration of actual user needs. Conclusion This study demonstrates the successful development and characterization of SCRAMM. It met ISO flow rate standards and remained under the 4.5 kg weight threshold preferred by end-users—outperforming current market leaders in portability while maintaining effective suction. These results highlight the importance of incorporating a performance-to-weight metric in evaluating portable suction devices. We recommend that future standards balance performance with portability to better suit military and emergency medical needs. Clinical trial number: not applicable.
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spelling doaj-art-cf606caeb8f04d4f880b79d6e53303f52025-08-20T03:42:37ZengBMCBMC Emergency Medicine1471-227X2025-07-0125111110.1186/s12873-025-01262-4Enhancing military airway suction devices with a focus on performance and portabilityMaria J. Londono0Saketh R. Peri1Rakib Hasan2Connor J. Evans3David Restrepo4Robert A. De Lorenzo5R. Lyle Hood6Department of Mechanical, Aerospace, and Industrial Engineering, University of Texas at San AntonioDepartment of Emergency Medicine, University of Texas Health Science Center at San AntonioDepartment of Mechanical, Aerospace, and Industrial Engineering, University of Texas at San AntonioDepartment of Mechanical, Aerospace, and Industrial Engineering, University of Texas at San AntonioDepartment of Mechanical, Aerospace, and Industrial Engineering, University of Texas at San AntonioDepartment of Mechanical, Aerospace, and Industrial Engineering, University of Texas at San AntonioDepartment of Mechanical, Aerospace, and Industrial Engineering, University of Texas at San AntonioAbstract Background Airway management is critical in combat casualty care, with airway compromise being the second leading cause of preventable battlefield deaths. Suction devices are essential for clearing obstructions during airway management; however, many medics choose not to carry them due to their excessive weight. Current standards for suction devices mention a minimum liquid flow rate of 1.2 L/min and a maximum device weight of 6 kg, but these standards fail to meet the practical needs of military end-users. The team conducted an I-Corps funded end-user assessment study with over 100 participants, in which a minimum flow rate of 1 L/min and a maximum weight of 4.5 kg were indicated as preferred among respondents. This gap between the standards and user preferences results in exclusion of existing devices from military kits due to weight concerns despite meeting performance criteria. Methods To address this gap, the Suction Combat Ready Advanced Multifunctional Machine (SCRAMM) was developed with input from U.S. Military clinical stakeholders to emphasize both performance and portability. SCRAMM is designed to handle diverse medical scenarios simultaneously and was characterized against the market leaders Zoll 330 and Impact 326M. Liquid flow rates and device weights were measured and analyzed according to ISO standards and end-user requirements. Results Zoll 330 and Impact 326M exceeded the ISO-required liquid flow rate by 145%, with weights of 4.8 kg and 5.1 kg, respectively. Additionally, both devices were heavier than the user-preferred weight limit of 4.5 kg. SCRAMM, with three suction lines for simultaneous diverse medical tasks, exceeded the ISO flow rate by 23%. It remained within the preferred weight range at 3.4 kg, demonstrating greater performance-to-weight balance in consideration of actual user needs. Conclusion This study demonstrates the successful development and characterization of SCRAMM. It met ISO flow rate standards and remained under the 4.5 kg weight threshold preferred by end-users—outperforming current market leaders in portability while maintaining effective suction. These results highlight the importance of incorporating a performance-to-weight metric in evaluating portable suction devices. We recommend that future standards balance performance with portability to better suit military and emergency medical needs. Clinical trial number: not applicable.https://doi.org/10.1186/s12873-025-01262-4Airway suctionMedical deviceEmergency medicineMilitary medicinePre-hospital
spellingShingle Maria J. Londono
Saketh R. Peri
Rakib Hasan
Connor J. Evans
David Restrepo
Robert A. De Lorenzo
R. Lyle Hood
Enhancing military airway suction devices with a focus on performance and portability
BMC Emergency Medicine
Airway suction
Medical device
Emergency medicine
Military medicine
Pre-hospital
title Enhancing military airway suction devices with a focus on performance and portability
title_full Enhancing military airway suction devices with a focus on performance and portability
title_fullStr Enhancing military airway suction devices with a focus on performance and portability
title_full_unstemmed Enhancing military airway suction devices with a focus on performance and portability
title_short Enhancing military airway suction devices with a focus on performance and portability
title_sort enhancing military airway suction devices with a focus on performance and portability
topic Airway suction
Medical device
Emergency medicine
Military medicine
Pre-hospital
url https://doi.org/10.1186/s12873-025-01262-4
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AT connorjevans enhancingmilitaryairwaysuctiondeviceswithafocusonperformanceandportability
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