Foley catheter balloon tamponade for penetrating neck injury management in military medicine: a case report

Abstract

Background
 The use of Foley catheter balloon tamponade (FCBT) to address bleeding in the neck and maxillofacial area associated with penetrating trauma is widely accepted in South African Emergency Departments. Its efficacy has been documented in combat settings in the Iraqi area of operations, with significant improvement of patients survival rate. Despite such evidence, Special Operations Forces (SOF) medics training in these techniques is limited.
 Case
 We present the case of a partner forces (PF) soldier that received shrapnel injuries during combat operations, resulting in life-threatening haemorrhage from the neck.
 Conclusion
 The Special Operations Forces medics who treated this patient decided to apply FCBT to prevent re-bleeding during an unsupervised ground vehicle movement to the host nation (HN) definitive care. None of the SOF medics involved had received formal training in the technique prior to the case. Their only knowledge was based on anecdotal evidence and self-study of the literature. Due to the lack of accountability by admitting a patient into the HN chain of care, there is no information on the outcome other than the patient survived. FCBT was performed after the wound was packed ineffectively with hemostatic gauze resulting in an unstable clot that failed with patient movement resulting in a probable carotid artery Zone I I neck bleed. FCBT has the potential to be a quick and effective adjunct to control bleeding in the complicated narrow track wound patterns in the neck and maxillofacial area that are not amenable to manual pressure or hemostatic agents in combat trauma medicine.
 Keywords
 Foley; Foley catheter balloon tamponade; Special Operations forces Medics; Bleeding.