The fully conscious, talking patient is able to maintain his own airway and needs no further airway manipulation. However patients' status may deteriorate at any time, and ABC's must constantly be reassessed.
The following categories of patients require a definitively secured airway :
- Apnoea
- Glasgow Coma Scale < 9 or sustained seizure activity
- Unstable mid-face trauma
- Airway injuries
- Large flail segment or respiratory failure
- High aspiration risk
- Inability to otherwise maintain an airway or oxygenation
The urgency of airway intubation is the most important factor in planning which technique of securing the airway is the safest and most appropriate. One must evaluate and assess the risk of further cord injury give head and neck movement, the degree of cooperation from the patient, anatomy and trauma to the airway and one's own expertise in each technique.
Reference :
http://www.trauma.org/archive/anaesthesia/airway.html
