Traumacast EAST/AAST/AAST-AMC: SCC Review Series - Airway Management
Feb 3, 2025
Dr. Carlos Brown, Chief of Acute Care Surgery at Dell Medical School, joins fellows Dr. Jennifer Brewer and Dr. Leah Aakjar to delve into the intricacies of airway management. They explore the challenges of managing airways in trauma cases, emphasizing the balance between hemorrhage control and airway stabilization. Discussion includes pharmacological insights for intubation, vital techniques for effective procedures, and the complexities involved in tracheostomy. They highlight the importance of teamwork and preparation in high-pressure critical care situations.
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Expect Limited Assessment Time
- In trauma/ICU emergent airways you have less assessment time and more physiologic instability, so plan quickly and conservatively.
- Prioritize resuscitation and expect limited apneic tolerance during intubation attempts.
Circulation May Precede Airway
- Prioritize hemorrhage control and circulation before airway when patients are hemodynamically unstable.
- Temporary measures and push-dose vasopressors can stabilize patients before induction to avoid arrest.
Use Scores But Assume Difficulty
- Use quick airway scores (Mallampati, MACOCHA) when feasible to predict difficulty, but adapt to time constraints.
- In critical settings, assume higher difficulty and prepare accordingly.