Stepwise airway management in the trauma patient

Abstract

The importance of establishing and maintaining a patent airway is a well-recognized principle in the resuscitation of all trauma victims. Many currently available guidelines for airway management in trauma patients have been aimed largely at anaesthetists or those with anaesthetic training. Typically they concen trate on either those patients who require intubation, with techniques to use when this fails, or those in whom little intervention beyond facemask oxygen is required. In reality, clinicians with varying degrees of skill will be faced with managing the trauma patient’s airway and many will not be able to safely attempt tracheal intubation. A pragmatic approach to airway assessment and management is presented that recognizes the variation in skills between clinicians. We also suggest that the role of supraglottic airway devices should now be recognized by all clinicians involved with airway management, particularly those not skilled in tracheal intubation and they should become an integral part of airway management.