Management of Breathing and Ventilation

Complex maxillofacial trauma

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  Midface fractures

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  Bilateral mandibular body fracture

Severe brain injury (GCS score <8), leading to decreased central respiratory drive

Comatose patients

Hemorrhagic shock

High cervical spine injury

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  High cervical cord injury at C3/4 level may paralyze or weaken diaphragm and chest wall motion, leading to respiratory compromise.

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  High cervical injuries can cause retropharyngeal edema or hematoma with airway obstruction.

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  Common high cervical spine injuries

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    Burst fracture dislocations

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    Facet dislocations

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    Atlantooccipital injury

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    C1 ring fracture (Jefferson-type fracture)

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    C2 type III odontoid fracture

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    C2 fracture (hangman’s type): fractures of bilateral pedicles with traumatic spondylolisthesis

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    Posterior arch fractures

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    Teardrop body fractures

Inhalation injury

Penetrating neck injury

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  Vascular trauma with significant neck hematoma

Airway injury

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  Tracheal injury

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  Laryngeal injury

Massive hemothorax

Tension pneumothorax

Multiple rib fractures with flail chest

Severe pulmonary contusion

Sucking chest wound

Small hemothorax

Small pneumothorax

Multiple rib fractures

Pulmonary contusion