Difficult Airway and Trauma

[DrRobert]

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While rapid sequence induction with cricoid pressure and DL seems to be the gold standard for trauma cases, what if the airway exam points toward a difficult intubation?

In "urgent" cases you have time to prepare a relatively elegant awake fiberoptic intubation.

But in the true emergency or trauma, where time is short, what are your options?

 

[huktonfonix]

There are very few " airway emergencies" in which you cant bag/mask or use some sort of back up plan (LMA, etc...) to buy time while you obtain proper equipment. A trauma patient is not an "airway emergency" in my opinion unless you cant ventilate him at all. You can argue for aspiration risk, but you can aspirate around an ETT also. We do an occasional emergency C section with an LMA if we cant intubate. I'd prefer not to, but its better than having no airway. Basically, you just run the dificult airway algorithm. If you need to trach him, do it.