Facial Trauma Airway

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Airway situation

Facial Trauma Airway

Facial trauma airways fail from blood, distorted anatomy, hypoxia, and delayed rescue transition.

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Clinical-use limit: Educational resource and cognitive-aid guide only; not a bedside order set or substitute for local protocol, medical direction, or clinical judgment.

Before intubation

  • Stage two suctions, blood products/resuscitation, C-spine strategy, and surgical airway kit.
  • Plan for anatomy distortion and failed view; assign roles and backup operator.
  • Consider whether oral, nasal, or surgical approach is contraindicated/appropriate based on injury.

During intubation

  • Suction aggressively and maintain oxygenation between attempts.
  • Do not keep repeating the same failed view in a contaminated airway.
  • Move early to rescue oxygenation or front-of-neck access when oxygenation fails.

After intubation

  • Secure tube carefully; reassess after movement/CT/transport.
  • Continue hemorrhage control and trauma pathway.
  • Communicate injury pattern and airway difficulty.

Common pitfalls

  • Single suction only.
  • Delayed cric in cannot oxygenate/cannot intubate.
  • Tube dislodgement during trauma movement.

Related resources

SALAD Panopto searchCritical checklist

References and anchors

ACEP adult ED intubation clinical policyACEP rapid-sequence intubation policy statementACEP mechanical ventilation policy statement

Educational resource only. Use institutional protocols, local policy, and bedside clinical judgment. This site is not a substitute for supervised clinical training or emergency care guidance.