{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:35:02Z","timestamp":1793385302682,"version":"4.5.0"},"reference-count":46,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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\u2009L\/min and a maximum device weight of 6\u2009kg, 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\u2009L\/min and a maximum weight of 4.5\u2009kg 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Zoll 330 and Impact 326M exceeded the ISO-required liquid flow rate by 145%, with weights of 4.8\u2009kg and 5.1\u2009kg, respectively. Additionally, both devices were heavier than the user-preferred weight limit of 4.5\u2009kg. 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\u2009kg, demonstrating greater performance-to-weight balance in consideration of actual user needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates the successful development and characterization of SCRAMM. It met ISO flow rate standards and remained under the 4.5\u2009kg weight threshold preferred by end-users\u2014outperforming 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12873-025-01262-4","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T13:00:31Z","timestamp":1752670831000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Enhancing military airway suction devices with a focus on performance and portability"],"prefix":"10.1186","volume":"25","author":[{"given":"Maria J.","family":"Londono","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saketh R.","family":"Peri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakib","family":"Hasan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connor J.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Restrepo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"De Lorenzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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These activities were limited to general, non-sensitive feedback and did not involve identifiable or sensitive information. The study was conducted in accordance with institutional guidelines and the ethical principles outlined in the Belmont Report and the U.S. Common Rule (45 CFR 46), under which the research was deemed exempt from formal Institutional Review Board (IRB) review under section 45 CFR 46.104. Because the data collection was anonymous and focused solely on general end-user feedback without identifying information, formal informed consent procedures were not required. This determination follows institutional standards and national regulations, as outlined in the Common Rule exemptions (45 CFR 46.104), which do not mandate consent for exempt activities that involve only non-identifiable, non-sensitive data. Additionally, institutional approval for the reporting and publication of the SCRAMM device was granted, and a patent application for the device has been formally filed. All information disclosed in this manuscript complies with institutional disclosure and intellectual property policies.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"No applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"MJL, SRP, RH, CJE, and DR declare that they have no competing interests. RDL and RLH disclose a conflict of interest as principals of EmergenceMed, LLC, a company involved in the development of new airway management technologies.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"128"}}