Airway management in neurotrauma care

Abstract

The predictability of the airway compromise affects the decision for tracheal intubation. Associated specific injuries, clinical presentation, and expected deterioration are the deciding factors regarding the need for securing the airway. Emergent or semi-urgent intubations are straightforward in the majority of patients. Airway management in trauma patients aims to improve tissue oxygenation, ensure ventilatory exchange, stabilize other injuries and prevent aspiration. Airway management in the trauma and emergency room is challenging as the emergency team has limited time for full airway assessment unlike pre-anaesthesia check-up clinic/operative room. The airway cart must be checked routinely in the emergency room for the working condition of the equipment and its availability. All trauma patients must be considered to have cervical spine injuries unless ruled out. The airway management for trauma patients is best done using a team approach including emergency medicine physicians, anesthesiologists, surgeons, and trained paramedical staff. Regardless of the emergency room setting, airway management of a trauma patient requires effective communication and efficient teamwork.

Keywords

• neurocritical care
• traumatic brain injury
• airway management
• neurotrauma