Airway Equipment Stephen Estime, MD; Abdullah Hasan Pratt, MD; Nicholas Ludmer, MD UChicago Medicine
Airway trauma is a critical and potentially life-threatening condition, and timely diagnosis and management is imperative for patient survival, as concomitant injuries and nonspecific symptoms may otherwise lead to fatal outcomes. Efficient airway management is paramount to addressing airway trauma, necessitating a comprehensive approach involving timely diagnosis, appropriate interventions, and the use of specialized equipment to ensure optimal patient outcomes.
Prompt and efficient management not only ensures the patient’s immediate survival but also plays a pivotal role in minimizing the impact on respiratory function and overall quality of life. The main objective is to establish a secure and patent airway, enabling efficient ventilation and later surgical repair. This video delivers a thorough and detailed exposition of the equipment utilized in airway management.
Airway Management: Techniques and Equipment Dany Accilien, MD*, Dexter C. Graves, MD*, Nicholas Ludmer, MD†, Stephen Estime, MD†, Abdullah Hasan Pratt, MD UChicago Medicine
This video article discusses airway management techniques in trauma resuscitation. It outlines the preparation and equipment used in patients with impending airway failure that require airway protection and ventilatory support. We discuss the innovative airway towers used in the University of Chicago emergency room as well as the general approach to airway management. We also go over the different types of laryngoscopy, assist devices, and cricothyroidotomy surgical airway procedures.
Airway injury remains a leading cause of early mortality in patients with trauma. Despite its rarity, direct traumatic airway injury and tracheobronchial injury (TBI) pose significant challenges for emergency clinicians, with an estimated incidence of 0.5–2% among trauma patients. Blunt or penetrating injuries to the head, oropharynx, neck, or upper chest can result in immediate or delayed airway blockage. Trauma can cause airway obstruction by itself or by blood clots, tissue edema, or gastric contents clogging the airway lumen. The added complexity of associated spinal injuries further underscores the need for precise and timely airway assessment.
In the context of trauma patients, a fundamental aspect of care involves prompt airway assessment. The Advanced Trauma Life Support (ATLS) algorithm, a cornerstone in trauma care, outlines a systematic approach focusing on a sequential assessment and management of Airway, Breathing, Circulation, Disability, and Exposure (ABCDE), as part of the initial evaluation of the injured individual. While adapted for battle and disaster environments, the ATLS algorithm consistently emphasizes the timely assessment and treatment of life-threatening airway and breathing issues before shifting focus to circulation problems. The CAB sequence has become more widely embraced in the last ten years, surpassing the airway-breathing-circulation (ABC) model for individuals with serious bleeding injuries. When bleeding is severe or life-threatening, prioritizing control of the bleeding takes precedence over interventions related to airway and breathing․
