DISRUPTED FACE OR NECK ANATOMY 

If managing an isolated injury that disrupts face or neck anatomy, healthy adults may only need treatment of the physical airway obstruction. Examples of conditions requiring early airway management include:

• Massive facial trauma
• Burns to the face or inhalation injury with hoarseness or stridor
• Massive neck trauma
• Expanding neck mass/hematoma
• Acute pharyngeal infection (Retropharyngeal abscess, peritonsillar abscess, epiglottitis)
• Foreign body aspiration
• Anaphylaxis (airway swelling)

INSUFFICIENT OXYGENATION OR VENTILATION 

These indications may be apparent on initial evaluation or may emerge during the course of patient care.  If the need to establish an airway develops more gradually, additional elective airway techniques can be employed.  Interventions such as prolonged manual bag or mechanical ventilation require an airway intervention to ensure best overall management.  Examples include:

• Chest wall and pulmonary trauma (blunt or penetrating) such as flail segments, pulmonary contusions (from blast, blunt or crush mechanism)
• Burns with greater than 40% body surface area
• Traumatic brain injury with decreased level of consciousness and inability to protect their airway (GCS ≤ 8)
• Procedural sedation or surgical procedure
• Respiratory failure (inability to oxygenate or ventilate) from disease, infection, or injury