Features  |   April 2013
Airway Management Controversies in Trauma Care
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Airway Management / Trauma / Burn Care / Features
Features   |   April 2013
Airway Management Controversies in Trauma Care
ASA Monitor 04 2013, Vol.77, 12-14.
ASA Monitor 04 2013, Vol.77, 12-14.
“ The most savage controversies are about matters as to which there is no good evidence either way.”
— Bertrand Russell
Although the number of anesthesiologists with a dedicated trauma-based practice is very small, the majority of anesthesiologists can still encounter trauma patients requiring urgent airway management. Whether we are providing primary coverage in the emergency department (ED), backing up the ED staff for difficult or failed intubations or taking the patient to the operating room, these patients can present many challenges. Hemodynamic instability, time pressure, lack of patient cooperation, risk of aspiration, need for cervical spine protection and facial injuries frequently contribute to the difficulty of airway management. The ASA Difficult Airway Algorithm continues to serve as a starting point for trauma airway management, but may require modifications as outlined by William Wilson, M.D. in a previous edition of the ASA NEWSLETTER.1  Such strategy differs from the ASA algorithm in that waking up the patient or canceling the procedure is rarely an option because the need for emergency airway control will presumably remain. This article focuses on recent developments in airway management, published recommendations and practice observations that may alter the approach to these challenging patients.
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