Trauma

Facial trauma / blood-soiled airway

Before / During / After / Pitfalls

Before

• Two suctions tested and in hand; consider SALAD-style continuous suction strategy.
• Prepare VL/DL, bougie, cric kit, and blood/emesis management.
• Assess for C-spine, facial instability, midface trauma, and need for surgical airway backup.

During

• Suction first, suction continuously, and do not pass into a dark contaminated view.
• Use the device/operator most likely to succeed quickly; change approach early if view is lost.
• Have cric trigger explicit if oxygenation/visualization fails.

After

• Secure tube carefully; facial injuries make dislodgement risk higher.
• Ongoing hemorrhage/aspiration management and imaging/ENT/trauma pathway.
• Recheck tube depth after movement/transport.

Pitfalls

• One weak Yankauer only.
• Repeated attempts through blood without changing technique.
• Failure to prepare front-of-neck access.