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Respiratory Failure in Combat Trauma: Role 1–Role 2 Principles and Monitoring

Respiratory failure in combat trauma rarely has a single cause—and at Role 2, airway decisions must anticipate what may happen during evacuation. Anesthesiologist Olha Haas translates nearly three years of work in the Zaporizhzhia region into a practical framework for recognizing deterioration, choosing when to intubate, and initiating safe ventilation.

The session covers bedside ultrasound for pneumothorax, hemothorax, and tube verification; RSI preparation for the “full stomach” trauma patient; initial ventilator settings; and systematic troubleshooting of high or low airway pressures. Capnography is explored beyond a single number, including waveform interpretation, perfusion changes, CPR monitoring, and patterns that can create false reassurance.

The transport section examines oxygen planning and the trade-offs between cylinders, concentrators, and turbine ventilators under drone threat. A multidisciplinary discussion then moves into pleural blood autotransfusion, profound hemorrhagic shock, positive-pressure ventilation, vascular access, and REBOA—where surgical speed and physiological timing must become one strategy.

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