Airway management: considerations in the trauma patient

The five components integral to modern, sophisticated airway management in trauma patients include equipment, pharmacologic adjuncts, manual techniques, physical circumstances, and patient profile. Although there is a finite number of pieces and types of equipment, pharmacologic adjuncts, and manual techniques, the last two components are variable. For purposes of brevity and clarity, this article has presented definitive airway management in terms of a well-organized, fully-equipped admitting (resuscitation) area of a trauma center, but a trauma patient may require airway management in a variety of physical circumstances, including the field, the transport vehicle, and numerous locations within the trauma center. We believe that the commonly used airway management algorithms are a poor substitute for a conceptual understanding of the basic principles of the five components of airway management, although these decision trees may be useful as learning tools. The construction of a truly complete decision tree is virtually impossible because of the high number of individual patient profiles.