Role of the emergency medicine physician in airway management of the trauma patient

J Trauma. 2001 Dec;51(6):1065-8. doi: 10.1097/00005373-200112000-00007.


Background: A Level I trauma center recently underwent a policy change wherein airway management of the trauma patient is under the auspices of Emergency Medicine (EM) rather than Anesthesiology.

Methods: We prospectively collected data on 11 months of EM intubations (EMI) since this policy change and compared them to the last year of Anesthesia-managed intubations (ANI) to answer the following questions: (1) Is intubation of trauma patients being accomplished effectively by EM? (2) Has there been a change in complication rates since the policy change? (3) How does the complication rate at our trauma center compare with other institutions?

Results: EM residents successfully intubated trauma patients on their first attempt 73.7% of the time compared with 77.2% ANI. The overall success rates, i.e., securing the airway within three attempts, were 97.0% (EMI) and 98.0% (ANI). The airway was successfully secured by EMI 100% of the time while a surgical airway was performed in two ANIs.

Conclusion: EM residents and staff can safely manage the airway of trauma patients. There is no statistically significant difference in peri-intubation complications. The complication rate for EDI (33%) and ANI (38%) is higher than reported in the literature, although the populations are not entirely comparable.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Airway Obstruction / therapy*
  • Clinical Competence*
  • Emergency Service, Hospital / standards
  • Emergency Treatment / standards*
  • Female
  • Glasgow Coma Scale
  • Humans
  • Intubation, Intratracheal / standards*
  • Male
  • Middle Aged
  • Pennsylvania
  • Physician's Role*
  • Prospective Studies
  • Trauma Centers
  • Trauma Severity Indices