Of 6088 patients requiring intubation within the first hour of arrival at a Level 1 trauma centre, 21 (0.3%) required a surgical airway for unanticipated difficult upper airway anatomy. There were no deaths from failed airway management. The authors ascribe their effective airway management to a simple protocol based on rapid sequence induction of anesthesia, judicious use of selected adjunctive devices (bougie, LMA), and the supervision by a small group of experienced anesthesiologists.
The Success of Emergency Endotracheal Intubation in Trauma Patients: A 10-Year Experience at a Major Adult Trauma Referral Center
Anesth Analg. 2009 Sep;109(3):866-72