Trauma intubations: can a protocol-driven approach be successful?

To determine the success rate of a trauma airway protocol.

This was a prospective cohort study of trauma patients requiring intubation conducted for 24 months. The study facility is a Level I trauma center serving an urban population. The protocol suggests that the first two attempts at intubation be by the third-year emergency medicine resident, a hospital-wide stat overhead page for anesthesia occurs, which results in anesthesia (occasionally a resident only, but usually an attending) presence in the trauma room in 5 to 10 minutes. After each intubation, the emergency medicine resident or the attending physician completed a data collection form indicating the number of intubation attempts and result of each one, who performed each attempt, complications related to each attempt, and airway adjuncts used.

Two hundred seventy-four patients were intubated during the study period by either emergency medicine physician or anesthesiologist with a success rate of 91.6% after the third attempt. The complication and cricothyrotomy rates were 9.8% and 2.6%, respectively.

Our trauma airway protocol allows for the safe and effective management of the trauma airway.