Which field technique may be used if endotracheal intubation fails in a trauma patient?

• A. Administer high-dose sedatives to facilitate intubation.
• B. Use a supraglottic airway device alone as a definitive airway.
• C. Use a supraglottic airway device or perform cricothyrotomy as a last resort.
• D. Wait for definitive airway from the evacuation team.

Answer: (C)

When a trauma patient cannot be intubated, the immediate goal is to keep the airway open and ensure ventilation. A supraglottic airway device can be placed quickly to establish effective ventilation and oxygenation while avoiding prolonged, difficult attempts at intubation. It serves as a rapid rescue option to momentarily bridge to a more secure airway.

If ventilation or oxygenation cannot be achieved with a supraglottic device, a surgical airway through the cricothyrotomy becomes necessary. This is considered a last resort because it is an invasive procedure with higher risk, but it bypasses upper airway obstructions to secure the airway when other methods fail.

High-dose sedatives to facilitate intubation are not appropriate in this setting, as they depress respiration and can worsen breathing and perfusion in a patient who already needs airway support. Waiting for evacuation to provide a definitive airway can lead to dangerous delays in a patient who is not ventilating adequately.