Current Concepts of Airway Management in the ICU and the Emergency Department

Abstract

Effective airway management is a central part of emergency medicine, and many consider it as an undisputable core skill for emergency physicians [1]. The failure to establish and maintain adequate gas exchange can be catastrophic and may have important medicolegal implications. Emergency airway management in the field and in the emergency department is often challenging for the physician in charge. Trauma patients pose specific airway problems: unfavorable conditions (e.g., darkness, inadequate space, limited access to the airway, poor patient positioning, unknown assisting personnel with different levels of training, etc.) contribute to failed endotracheal intubation as much as patient peculiarities, e.g., oropharyngeal or pulmonary hemorrhage, facial trauma, or immobilized cervical spine. All these factors, as well as poor skills of physicians themselves, result in a difficult airway in 7–10% of patients who require emergency endotracheal intubation in the field or in the emergency department [2]–[4].