Management of the trauma patient’s airway – pearls and pitfalls

How Do I Adequately Assess the Airway?

The LEMON mnemonic is one of the most commonly utilized airway assessment tools, and is recommended by the most recent Advanced Trauma Life Support (ATLS) guidelines.

Which Trauma Patients Should I Intubate?

  • Airway protection
  • Oxygenation
  • Ventilation
  • Preoperative management (i.e. patients with painful injuries or undergoing painful procedures before non-emergent operation)

 

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How to predict you’re about to send your patient to their maker with your intubation if you’re not well prepared

The 3-3-2 rule is part of the evaluation in a patient for a predicted difficult airway. This evaluation can be done on an unconscious patient in supine position and is reliable tool for the anticipation of a difficult BVM ventilation and intubation out of the hospital.

 

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Anatomy of the Adult Endotracheal Tube

DID YOU KNOW: The endotracheal tube cuff does not cause complete occlusion beyond it, so some secretions will still travel past as there will be some fine folds around it. However, it will prevent aspiration of larger objects/secretions.

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Understanding intubation and ventilation…the Pearls and Pitfalls

A normal minute ventilation involves a minute ventilation between 5 and 8 L [ie, 500–600 mL, rate 10–14 breaths/minute]. In severely ill COPD and asthma patients, overventilation risks auto-PEEP and barotrauma; a starting rate of six breaths with a 500 mL volume allows maximum time for exhalation.

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