Nasotracheal Intubation in the Presence of Frontobasal Skull Fracture

Arrowsmith, Joseph E.; Robertshaw, Heidi; Boyd, Juliet D.

doi:10.1097/00132586-199812000-00055

Cited by 1 publication

(1 citation statement)

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“…14,[20][21][22][23] The transnasal route is chosen, because patients better tolerate the transnasal passage of the tube after decongestion and topical anesthesia of the nasal mucosa (we use 0.5 mL of a 10% cocaine hydrochloride solution) compared with the transoral route. 24 Epistaxis and fractures of the skull base need not to be contraindications, 25,26 as long as the endoscope and the tube are inserted and advanced under visual control and not in a blind way.…”

Section: Introductionmentioning

confidence: 99%

Airway Management in Facial Trauma Patients

Jacomet

Tasman

2015

Facial plast Surg

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Airway management in craniofacial trauma patients is a challenge for an anesthetist. Treating these patients requires a close interdisciplinary communication and cooperation. Maintaining the airway and oxygenation of the patient is the initial challenge in craniofacial trauma patients. The management of the difficult airway is facilitated and patient's safety improved by following one of several published difficult airway algorithms. We describe the St. Gallen difficult airway algorithm for the management of difficult airway in general and the airway in facial trauma patients in particular. Whenever possible, the airway should be secured in a conscious and spontaneously breathing patient. It is important to be familiar with different techniques and to change the approach after two unsuccessful attempts with one technique. Once the airway is established, all available preventive measures should be used to avoid losing the airway. A tracheotomy has its place in a significant number of patients in whom an immediate postoperative or a delayed extubation appears unfeasible.

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