Indications for Definitive Airway In Trauma Patients, Table 2.1 from Advanced Trauma Life Support

Trauma patients need a definitive airway (meaning usually endotracheal intubation) for airway protection and for when ventilation or oxygenation is necessary.*

Table 2.1 Indications for Definitive Airway
NEED FOR AIRWAY PROTECTION	NEED FOR VENTILATION OR OXYGENATION
Severe maxillofacial fractures	Inadequate respiratory efforts Tachypnea Hypoxia Hypercarbia Cyanosis
Risk for obstruction Neck hematoma Laryngeal or tracheal injury Stridor	Massive blood loss and need for volume resuscitation
Risk for aspiration Bleeding Vomitting	Severe closed head injury with need for brief hyperventilation if acute neurologic deterioration occurs
Unconscious	Apnea Neuromuscular paralysis Unconscious

“Patients with GCS scores of 8 or less require prompt intubation. If there is no immediate need for intubation, radiological clearance of the c-spine may be obtained.”*

*Advanced Trauma Life Support Student Course Manual, 9th ed, American College of Surgeons,Chapter 10: Pediatric Trauma. p. 41.