gency Medicine, Mount Auburn Hospital,

Orotracheal intubation is indicated in any situation that requires definitive control of the airway. Orotracheal intubation is commonly performed to facilitate control of the airway in a patient undergoing general anesthesia. It is also performed as part of the care of critically ill patients with multisystem disease or injuries. Emer-gency indications include cardiac or respiratory arrest, failure to protect the airway from aspiration, inadequate oxygenation or ventilation, and existing or anticipated airway obstruction. CONTRAINDICATIONS In urgent situations or emergencies, such as when a patient is in cardiac arrest, airway management is of paramount importance, and there are very few contra-indications to orotracheal intubation. Orotracheal intubation by direct laryngos-copy is somewhat contraindicated in a patient with partial transection of the trachea, because the procedure can cause complete tracheal transection and loss of the air-way. In these cases, surgical airway management may be necessary. Unstable cervical spine injury is not a contraindication, but strict, in-line stabilization of the cervica