Airway situation
TBI / intracranial pressure risk
Type: Trauma
Before
- Avoid hypoxia and hypotension; preoxygenate and resuscitate before induction when possible.
- Set BP/EtCO2 targets with trauma/neuro team if available.
- Plan sedation/analgesia to prevent coughing/agitation after tube.
During
- Smooth, fast airway with hemodynamic protection.
- Avoid prolonged hypoxia/apnea.
- Confirm tube and control ventilation intentionally.
After
- Target EtCO2 per local neuro/trauma policy.
- Maintain oxygenation, BP, sedation, head positioning, and imaging/definitive care.
- Avoid reflex hyperventilation unless herniation protocol or specialist direction.
Pitfalls
- Post-intubation hypotension.
- Unintentional hyper/hypoventilation.
- Forgetting sedation after paralysis.