Facial plast Surg 2015; 31(04): 319-324
DOI: 10.1055/s-0035-1562883
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Airway Management in Facial Trauma Patients

Alfred Jacomet1, Abel-Jan Tasman2
  • 1Division of Anesthesiology, Intensive Care, Rescue and Pain Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland
  • 2Division of Facial Plastic Surgery, Department of ENT, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
Further Information

Publication History

Publication Date:
15 September 2015 (online)

Abstract

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.