The Traumatic Airway: The Anesthesiologist’s Role in the Emergency Room

A 1997 survey of nonoperating room emergency airway management and endotracheal intubation practices in the United States revealed that, in 45 % of institutions, intubations in the emergency department (ED) were performed by emergency medical physicians, 32 % by anesthesiology personnel, and 19 % by both. Airway management in trauma patients, however, remains the domain of anesthesiologists.1 The anesthesiologist, as one of the airway experts, should be consulted early when airway control may be required in trauma patients. In most major trauma centers, anesthesiologists have become part of the ED team evaluating the incoming trauma patient. As part of this role, the anesthe-siologist needs to be aware of technical and medical issues specific to the trauma victim. Patients do not always require intubation initially; there-fore, obtaining control of the at-risk or potentially at-risk airway is a prob-lem not just in the ED but later in the intensive care unit and in the operating room as well. The trauma patient whose airway requires secur