The safety of awake tracheal intubation in cervical spine injury
- PMID: 1544191
- DOI: 10.1007/BF03008639
The safety of awake tracheal intubation in cervical spine injury
Abstract
As a referral centre for cervical spine injuries, we have routinely performed awake tracheal intubation when intubation was indicated. A retrospective case control study was undertaken to review the frequency of neurological deterioration and aspiration associated with our approach. Neurological deterioration was assessed by a change in level of injury or neurological grade at admission and discharge. Four hundred and fifty-four patients with critical cervical spine and/or cord injuries were reviewed over an eight-year period. A case group of 165 patients underwent tracheal intubation awake within two months of injury. A control group of 289 remained unintubated during the same period. A comparison of spinal neurological status between admission and discharge revealed no statistically significant difference in neurological deterioration between the two groups. This occurred despite a greater injury severity score in the case group. No evidence of aspiration during intubation was documented. We conclude that awake tracheal intubation is a safe method of airway management in patients with cervical spine injuries.
Comment in
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Tracheal intubation in the cervical spine-injured patient.Can J Anaesth. 1992 Feb;39(2):105-9. doi: 10.1007/BF03008637. Can J Anaesth. 1992. PMID: 1544189 English, French. No abstract available.
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