Trauma

TBI / intracranial pressure risk

Before / During / After / Pitfalls

Before

• Avoid hypoxia and hypotension; preoxygenate and resuscitate before induction when possible.
• Set BP/EtCO2 targets with trauma/neuro team if available.
• Plan sedation/analgesia to prevent coughing/agitation after tube.

During

• Smooth, fast airway with hemodynamic protection.
• Avoid prolonged hypoxia/apnea.
• Confirm tube and control ventilation intentionally.

After

• Target EtCO2 per local neuro/trauma policy.
• Maintain oxygenation, BP, sedation, head positioning, and imaging/definitive care.
• Avoid reflex hyperventilation unless herniation protocol or specialist direction.

Pitfalls

• Post-intubation hypotension.
• Unintentional hyper/hypoventilation.
• Forgetting sedation after paralysis.