Airway management in the blunt trauma patient: how important is the cervical spine?

Emergency airway management in the patient with blunt trauma is a clinical dilemma. Many of these patients require immediate airway management, but each method carries its own set of risks and benefits. At the heart of the issue is the long-standing belief that oral intubation is hazardous in the presence of an unstable injury to the cervical spine. In this article, the issues surrounding selection of an appropriate technique for airway management are reviewed critically. Recommendations are made for management of the airway in this high-risk group of patients with injury to the cervical spine.