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Article |

Orotracheal Intubation in Trauma Patients With Cervical Fractures

Gianna Scannell, MD; Kenneth Waxman, MD; Gail Tominaga, MD; Steven Barker, MD; Cheri Annas, RN
Arch Surg. 1993;128(8):903-906. doi:10.1001/archsurg.1993.01420200077014.
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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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