All trauma patients are assumed to have cervical spine injuries, and therefore c-spine stabilization should be maintained throughout all procedures. Many consider endotracheal intubation to be the 'gold standard' of airway control. It reduces aspiration risk, provides an alternative drug route, allows foreign body visualization and removal, and can be used in pediatric populations. Disadvantages of intubation include greater educational resources costs, greater initial equipment costs, more rapid skill extinction, and longer placement time compared with the non-visualized airway. Invasion of the airway in any way also increased the risk of infection.
Oral intubation uses direct visualization of the trachea.
Cricoid pressure is applied during oral intubation to prevent gastric distention or passive regurgitation. Breath sounds are assessed immediately post intubation and a CO2 detector helps to confirm placement. A chest x-ray is obtained after the intubation is complete for definitive confirmation of tube placement. RSI has gained increased popularity and use in the last 10 years. Prior to the mid 1980's, RSI was rarely utilized, and only a few facilities taught this technique.