Please enable JavaScript.

Coggle requires JavaScript to display documents.

Blunt airway trauma (Airway management (Preparation (Transfer patient to…

- - - - Gold standard: safest option if unable to tolerate the supine position (suspect laryngotracheal separation)
      - Spont vent maintained
    - - Need surgical expertise
      - Need patient cooperation (limited by hypoxia or confusion from other causes)
      - Difficult (oedema, haematoma, tenderness)
      - Need for urgency in securing the airway
      - No benefit if the injury is distal tracheal or bronchial level
  - - - Inhalation induction is theoretically superior: allows maintenance of spont vent and avoidance of PPV
      - Under direct vision (videolaryngoscopy useful)
      - Smaller ETT than usual to allow for anticipated airway narrowing
      - Surgeon present to perform emergency trache if intubation fails
    - - Cricoid pressure CI: may cause further airway disruption
      - PPV CI: May cause insufflation of air into neck
      - May be unable to pass ETT: false passage, completion of laryngotracheal separation
      - Aspiration risk
      - Left lateral position may be preferred but increases degree of difficulty
      - Likely to become haemodynamically unstable with sedation
  - - - Spontaneous ventilation maintained
      - Technique of choice for distal tracheal or bronchial injuries
    - - Difficult if ongoing haemorrhage
      - May worsen laryngotracheal separation
      - Likely to take longer than asleep intubation
      - Need experienced assistance
- - - - Blind nasal intubation: may result in completion of laryngotracheal separation
      - Cricothhroidotomy: cricoid is often the level of injury, may result in completion of laryngotracheal separation
      - Percutaneous tracheostomy - may worsen the injury
      - Rigid bronchoscopy: CI because the patient is presumed to have a C spine injury