Airway Management in Trauma Cases in Emergency Department
Year 2025,
Volume: 8 Issue: 1, 42 - 46, 29.03.2025
Volkan Arslan
Abstract
Trauma patients constitute a significant proportion of emergency department admissions. It is vital to have sufficient knowledge and experience in airway management of these patients. Choosing the most appropriate method for each patient may be the most challenging step for the practitioner. In particular, the fact that some generalizations are not supported by sufficient literature information makes this choice difficult. In this article, the options that can be used in airway management of trauma patients will be discussed.
Ethical Statement
Study is a literature summary/review. No ethical committe approvement is needed. Anyhow there is no ethical disturbances for this study.The author declare that he comply with research and publication ethics.
Supporting Institution
There is no supporting institution.
References
- Galbraith CM, Wagener BM, Chalkias A, Siddiqui S, Douin DJ. Massive Trauma and Resuscitation Strategies. Anesthesiol Clin. 2023;41(1):283-301.
- Network LER. Trauma in the United States https://lern.la.gov/trauma/u-s-and-la-trauma-statistics/trauma-in-the-u-s/#:~:text=TRAUMA%20IN%20THE%20UNITED%20STATES&text=The%20statistics%20are%20sobering.,children%20in%20the%20United%20States.2009 , access date: March 2025
- Galvagno SM, Jr., Nahmias JT, Young DA. Advanced Trauma Life Support(®) Update 2019: Management and Applications for Adults and Special Populations. Anesthesiol Clin. 2019;37(1):13-32.
- Horton CL, Brown CA, 3rd, Raja AS. Trauma airway management. J Emerg Med. 2014;46(6):814-20.
- Kovacs G, Sowers N. Airway Management in Trauma. Emerg Med Clin North Am. 2018;36(1):61-84.
- Langeron O, Birenbaum A, Amour J. Airway management in trauma. Minerva Anestesiol. 2009;75(5):307-11.
- Louro J, Varon AJ. Airway management in trauma. Int Anesthesiol Clin. 2021;59(2):10-6.
- Tobin JM, Varon AJ. Emergency management of the trauma airway. J Clin Anesth. 2013;25(7):605-7.
- Walrath BD, Harper S, Barnard E, Tobin JM, Drew B, Cunningham C, et al. Airway Management for Trauma Patients. Mil Med. 2018;183(suppl_2):29-31.
- Jishnu M, Bhoi S, Sahu AK, Suresh S, Aggarwal P. Airway management practices among emergency physicians: An observational study. Turk J Emerg Med. 2022;22(4):186-91.
- Levitan RM, Rosenblatt B, Meiner EM, Reilly PM, Hollander JE. Alternating day emergency medicine and anesthesia resident responsibility for management of the trauma airway: a study of laryngoscopy performance and intubation success. Ann Emerg Med. 2004;43(1):48-53.
- Cabrini L, Baiardo Redaelli M, Filippini M, Fominskiy E, Pasin L, Pintaudi M, et al. Tracheal intubation in patients at risk for cervical spinal cord injury: A systematic review. Acta Anaesthesiol Scand. 2020;64(4):443-54.
- Eugene V, Hutzler J, Kempema J, Bradford J, Brown CVR. The difficult airway in trauma: What you need to know. J Trauma Acute Care Surg. 2024;97(5):661-9.
- Kwan I, Bunn F, Roberts I. Spinal immobilisation for trauma patients. Cochrane Database Syst Rev. 2001;2001(2):Cd002803.
- Ollerton JE, Parr MJ, Harrison K, Hanrahan B, Sugrue M. Potential cervical spine injury and difficult airway management for emergency intubation of trauma adults in the emergency department--a systematic review. Emerg Med J. 2006;23(1):3-11.
- Wiles MD. Airway management in patients with suspected or confirmed traumatic spinal cord injury: a narrative review of current evidence. Anaesthesia. 2022;77(10):1120-8.
- Wiles MD, Iliff HA, Brooks K, Da Silva EJ, Donnellon M, Gardner A, et al. Airway management in patients with suspected or confirmed cervical spine injury: Guidelines from the Difficult Airway Society (DAS), Association of Anaesthetists (AoA), British Society of Orthopaedic Anaesthetists (BSOA), Intensive Care Society (ICS), Neuro Anaesthesia and Critical Care Society (NACCS), Faculty of Prehospital Care and Royal College of Emergency Medicine (RCEM). Anaesthesia. 2024;79(8):856-68.
- Barak M, Bahouth H, Leiser Y, Abu El-Naaj I. Airway Management of the Patient with Maxillofacial Trauma: Review of the Literature and Suggested Clinical Approach. Biomed Res Int. 2015;2015:724032.
- Jarvis JL, Panchal AR, Lyng JW, Bosson N, Donofrio-Odmann JJ, Braude DA, et al. Evidence-Based Guideline for Prehospital Airway Management. Prehosp Emerg Care. 2024;28(4):545-57.
- Patel A, Saadi R, Lighthall JG. Securing the Airway in Maxillofacial Trauma Patients: A Systematic Review of Techniques. Craniomaxillofac Trauma Reconstr. 2021;14(2):100-9.
- Chiumello D, Coppola S, Froio S, Gregoretti C, Consonni D. Noninvasive ventilation in chest trauma: systematic review and meta-analysis. Intensive Care Med. 2013;39(7):1171-80.
- Ahn H, Singh J, Nathens A, MacDonald RD, Travers A, Tallon J, et al. Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. J Neurotrauma. 2011;28(8):1341-61.
- Braithwaite S, Stephens C, Remick K, Barrett W, Guyette FX, Levy M, et al. Prehospital Trauma Airway Management: An NAEMSP Position Statement and Resource Document. Prehosp Emerg Care. 2022;26(sup1):64-71.
- Hernandez MC, Aho JM, Zielinski MD, Zietlow SP, Kim BD, Morris DS. Definitive airway management after pre-hospital supraglottic airway insertion: Outcomes and a management algorithm for trauma patients. Am J Emerg Med. 2018;36(1):114-9.
- Beckers SK, Brokmann JC, Rossaint R. Airway and ventilator management in trauma patients. Curr Opin Crit Care. 2014;20(6):626-31.
- Hansel J, Rogers AM, Lewis SR, Cook TM, Smith AF. Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation. Cochrane Database Syst Rev. 2022;4(4):Cd011136.
- Liao S, Popp E, Huttlin P, Weilbacher F, Munzberg M, Schneider N, et al. Cadaveric study of movement in the unstable upper cervical spine during emergency management: tracheal intubation and cervical spine immobilisation-a study protocol for a prospective randomised crossover trial. BMJ Open. 2017;7(8):e015307.
- Mayglothling J, Duane TM, Gibbs M, McCunn M, Legome E, Eastman AL, et al. Emergency tracheal intubation immediately following traumatic injury: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S333-40.
- Krepps AR, Douin DJ, Winkle JM, Wright FL, Fisher AD, April MD, et al. Characterizing emergency department surgical airway placement in the setting of trauma. Am J Emerg Med. 2024;85:48-51.
Acil Serviste Travma Hastalarında Havayolu Yönetimi
Year 2025,
Volume: 8 Issue: 1, 42 - 46, 29.03.2025
Volkan Arslan
Abstract
Travma hastaları acil servis başvurularının önemli bir kısmını oluşturmaktadır. Bu hastaların havayolu yönetiminde yeterli bilgi ve tecrübeye sahip olmak hayati önem taşımaktadır. Her hasta için en uygun yöntemin seçilmesi uygulayıcıyı en çok zorlayacak basamak olabilir. Özellikle de bazı genel kanıların yeterli literatür bilgisi ile desteklenmiyor olması bu seçimi zorlaştırmaktadır. Bu yazıda travma hastalarının havayolu yönetiminde kullanılabilecek seçenekler tartışılacaktır.
Ethical Statement
The author declare that he comply with research and publication ethics.
Supporting Institution
Destekleyen kurum yoktur.
References
- Galbraith CM, Wagener BM, Chalkias A, Siddiqui S, Douin DJ. Massive Trauma and Resuscitation Strategies. Anesthesiol Clin. 2023;41(1):283-301.
- Network LER. Trauma in the United States https://lern.la.gov/trauma/u-s-and-la-trauma-statistics/trauma-in-the-u-s/#:~:text=TRAUMA%20IN%20THE%20UNITED%20STATES&text=The%20statistics%20are%20sobering.,children%20in%20the%20United%20States.2009 , access date: March 2025
- Galvagno SM, Jr., Nahmias JT, Young DA. Advanced Trauma Life Support(®) Update 2019: Management and Applications for Adults and Special Populations. Anesthesiol Clin. 2019;37(1):13-32.
- Horton CL, Brown CA, 3rd, Raja AS. Trauma airway management. J Emerg Med. 2014;46(6):814-20.
- Kovacs G, Sowers N. Airway Management in Trauma. Emerg Med Clin North Am. 2018;36(1):61-84.
- Langeron O, Birenbaum A, Amour J. Airway management in trauma. Minerva Anestesiol. 2009;75(5):307-11.
- Louro J, Varon AJ. Airway management in trauma. Int Anesthesiol Clin. 2021;59(2):10-6.
- Tobin JM, Varon AJ. Emergency management of the trauma airway. J Clin Anesth. 2013;25(7):605-7.
- Walrath BD, Harper S, Barnard E, Tobin JM, Drew B, Cunningham C, et al. Airway Management for Trauma Patients. Mil Med. 2018;183(suppl_2):29-31.
- Jishnu M, Bhoi S, Sahu AK, Suresh S, Aggarwal P. Airway management practices among emergency physicians: An observational study. Turk J Emerg Med. 2022;22(4):186-91.
- Levitan RM, Rosenblatt B, Meiner EM, Reilly PM, Hollander JE. Alternating day emergency medicine and anesthesia resident responsibility for management of the trauma airway: a study of laryngoscopy performance and intubation success. Ann Emerg Med. 2004;43(1):48-53.
- Cabrini L, Baiardo Redaelli M, Filippini M, Fominskiy E, Pasin L, Pintaudi M, et al. Tracheal intubation in patients at risk for cervical spinal cord injury: A systematic review. Acta Anaesthesiol Scand. 2020;64(4):443-54.
- Eugene V, Hutzler J, Kempema J, Bradford J, Brown CVR. The difficult airway in trauma: What you need to know. J Trauma Acute Care Surg. 2024;97(5):661-9.
- Kwan I, Bunn F, Roberts I. Spinal immobilisation for trauma patients. Cochrane Database Syst Rev. 2001;2001(2):Cd002803.
- Ollerton JE, Parr MJ, Harrison K, Hanrahan B, Sugrue M. Potential cervical spine injury and difficult airway management for emergency intubation of trauma adults in the emergency department--a systematic review. Emerg Med J. 2006;23(1):3-11.
- Wiles MD. Airway management in patients with suspected or confirmed traumatic spinal cord injury: a narrative review of current evidence. Anaesthesia. 2022;77(10):1120-8.
- Wiles MD, Iliff HA, Brooks K, Da Silva EJ, Donnellon M, Gardner A, et al. Airway management in patients with suspected or confirmed cervical spine injury: Guidelines from the Difficult Airway Society (DAS), Association of Anaesthetists (AoA), British Society of Orthopaedic Anaesthetists (BSOA), Intensive Care Society (ICS), Neuro Anaesthesia and Critical Care Society (NACCS), Faculty of Prehospital Care and Royal College of Emergency Medicine (RCEM). Anaesthesia. 2024;79(8):856-68.
- Barak M, Bahouth H, Leiser Y, Abu El-Naaj I. Airway Management of the Patient with Maxillofacial Trauma: Review of the Literature and Suggested Clinical Approach. Biomed Res Int. 2015;2015:724032.
- Jarvis JL, Panchal AR, Lyng JW, Bosson N, Donofrio-Odmann JJ, Braude DA, et al. Evidence-Based Guideline for Prehospital Airway Management. Prehosp Emerg Care. 2024;28(4):545-57.
- Patel A, Saadi R, Lighthall JG. Securing the Airway in Maxillofacial Trauma Patients: A Systematic Review of Techniques. Craniomaxillofac Trauma Reconstr. 2021;14(2):100-9.
- Chiumello D, Coppola S, Froio S, Gregoretti C, Consonni D. Noninvasive ventilation in chest trauma: systematic review and meta-analysis. Intensive Care Med. 2013;39(7):1171-80.
- Ahn H, Singh J, Nathens A, MacDonald RD, Travers A, Tallon J, et al. Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. J Neurotrauma. 2011;28(8):1341-61.
- Braithwaite S, Stephens C, Remick K, Barrett W, Guyette FX, Levy M, et al. Prehospital Trauma Airway Management: An NAEMSP Position Statement and Resource Document. Prehosp Emerg Care. 2022;26(sup1):64-71.
- Hernandez MC, Aho JM, Zielinski MD, Zietlow SP, Kim BD, Morris DS. Definitive airway management after pre-hospital supraglottic airway insertion: Outcomes and a management algorithm for trauma patients. Am J Emerg Med. 2018;36(1):114-9.
- Beckers SK, Brokmann JC, Rossaint R. Airway and ventilator management in trauma patients. Curr Opin Crit Care. 2014;20(6):626-31.
- Hansel J, Rogers AM, Lewis SR, Cook TM, Smith AF. Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation. Cochrane Database Syst Rev. 2022;4(4):Cd011136.
- Liao S, Popp E, Huttlin P, Weilbacher F, Munzberg M, Schneider N, et al. Cadaveric study of movement in the unstable upper cervical spine during emergency management: tracheal intubation and cervical spine immobilisation-a study protocol for a prospective randomised crossover trial. BMJ Open. 2017;7(8):e015307.
- Mayglothling J, Duane TM, Gibbs M, McCunn M, Legome E, Eastman AL, et al. Emergency tracheal intubation immediately following traumatic injury: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S333-40.
- Krepps AR, Douin DJ, Winkle JM, Wright FL, Fisher AD, April MD, et al. Characterizing emergency department surgical airway placement in the setting of trauma. Am J Emerg Med. 2024;85:48-51.