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August 1993

Orotracheal Intubation in Trauma Patients With Cervical Fractures

Author Affiliations

From the Departments of Surgery (Drs Scannell, Waxman, and Tominaga and Ms Annas) and Anesthesiology (Dr Barker), University of California, Irvine.

Arch Surg. 1993;128(8):903-906. doi:10.1001/archsurg.1993.01420200077014

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.(Arch Surg. 1993;128:903-906)

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