An introduction to the initial hospital management of acute trauma

Airway management with cervical spine control

The patient should receive high flow Oxygen. An anaesthetist should assess and manage the airway: if the patient can talk, the airway is likely to be clear can breath, and has cerebral perfusion. If they have a reduced conscious level the patient may not be able to maintain their airway. Soot in the airway, hoarseness, stridor, foreign bodies, blood and lacerations should alert you to impending airway problems.

Assume cervical spine injury and maintain the spine in neutral position (hard collar, taped with sand bags wither side of the head) until proven otherwise clinically and radiologically. During intubation it is acceptable to remove the hard collar to aid jaw movement so long as someone performs ‘manual in line immobilisation’ of the head and neck.