Orotracheal intubation in trauma patients with cervical fractures

Arch Surg. 1993 Aug;128(8):903-5; discussion 905-6. 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.

MeSH terms

  • Accidents, Traffic
  • Cervical Vertebrae / injuries*
  • Emergency Medical Services
  • Humans
  • Intubation, Intratracheal / methods*
  • Retrospective Studies
  • Spinal Fractures / therapy*