The Japan Society of Neurotraumatology has listed indications for securing the airway of a patient with severe head injury.

Patient selection: severe head injury


Securing the airway may involve:

(1) oral intubation

(2) endotracheal intubation

(3) nasal or endoscopic intubation

(4) thyrocricotomy

Indications for intubating the patient:

(1) manual technique insufficient to maintain airway

(2) risk of aspiration of blood or vomitus

(3) risk of airway narrowing/obstruction from trauma, hematoma or other cause

(4) need for respiratory management (apnea, hypoventilation, hypoxemia not corrected by oxygen administration)

(5) severe hemorrhagic shock

(6) cardiac arrest

(7) decrease in level of consciousness (Glasgow Coma Scale < 8; best motor response <= 5)


Criteria for an airway emergency:

(1) patient non-responsive

(2) apnea

(3) agonal respirations

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