Maxillofacial trauma in the emergency department: Pearls and pitfalls in airway management

S. Coppola, S. Froio, G. Merli, D. Chiumello

Research output: Contribution to journalArticlepeer-review

Abstract

Maxillofacial trauma poses a challenge for the anesthesiologist because injuries can often compromise the patient's airways. Airway maintenance is the first step in the American College of Surgeons Advance Trauma Life Support (ATLS®) protocol. However, clinical dilemmas may arise about the best way to manage a potentially life-threatening injury. There are no recommendations about the best time to intubate, the warning signs for deciding to intubate, or which device should be used when difficulty is expected. In this context the ATLS® approach is important but not sufficient. It is also necessary to recognize and be able to manage specific problems in this scenario where clinical priorities may be conflicting, may suddenly change or may be hidden. This clinical review discusses the complexity of this scenario, providing an overview of the conditions at greatest risk for airway obstruction and the options for airway management, on the basis of the recent literature. Clinicians must recognize the milestones and pitfalls of this topic in order to adopt a systematic approach for airway management, to identify specific characteristics associated with it, and to establish the utility of different instruments for airway management.

Original languageEnglish
Pages (from-to)1346-1358
Number of pages13
JournalMinerva Anestesiologica
Volume81
Issue number12
Publication statusPublished - Dec 1 2015

Keywords

  • Airway management
  • Airway obstruction
  • Emergency service
  • Hospital
  • Injuries
  • Maxillofacial injuries
  • Spine

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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