Orotracheal intubation in trauma patients with cervical fractures
G. Scannell, K. Waxman, G. Tominaga, S. Barker and C. Annas
Department of Surgery, University of California, Irvine.
OBJECTIVE: To evaluate orotracheal intubation with in-line stabilization of
the cervical spine for emergency airway treatment of trauma patients with
cervical spine injuries. DESIGN: Of 7518 trauma patients examined, 81
patients with cervical spine injuries received emergency orotracheal
intubation. All intubations were performed by experienced
anesthesiologists, with a separate individual maintaining in-line
stabilization. Neurologic examination was documented before and after
intubation. RESULTS: Peripheral neurologic deficit was present from the
outset in 20 patients. There were unstable cervical fractures in 38
patients with no neurologic deficit. Twenty-three patients were
neurologically intact with fractures that were later judged stable. In no
instance was there a deterioration of neurologic status following
intubation. Peripheral neurologic deficits improved after intubation in
four patients. CONCLUSION: Orotracheal intubation, performed with manual
in-line stabilization by trained and experienced personnel, is a safe
emergency procedure in patients with cervical fractures.
