Airway Management in the Trauma Patient

Posted by e-Medical PPT
Airway and Ventilation Methods
Orotracheal Intubation- preferred in almost all situations
Indications
   present or impending respiratory failure
   apnea
   unable to protect own airway (<8)
Advantages
   secures airway
   route for a few medications
   optimizes ventilation and oxygenation

Nasotracheal Intubation-  rarely if ever used in the initial management of the injured patient.
Many drawbacks
Goal of safe endotracheal intubation with cervical spine precautions can be better accomplished with orotracheal intubation

Surgical Cricothyrotomy
Indications
  absolute need for a definitive airway AND
   unable to perform ETT due for structural or anatomic reasons, AND
   risk of not intubating is > surgical airway risk
OR
  absolute need for a definitive airway AND
   unable to clear an upper airway obstruction, AND
   multiple unsuccessful attempts at ETT, AND
   other methods of ventilation do not allow for effective ventilation and respiration

Surgical Cricothyrotomy
Contraindications (relative)
Age < 8 years (some say 10)
evidence of fx larynx or cricoid cartilage
evidence of tracheal transection

Needle Cricothyrotomy & Transtracheal Jet Ventilation
Indications
Same as surgical cricothyrotomy along with
Contraindication for surgical cricothyrotomy
Contraindications
caution with tracheal transection


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