Vomit, Blood, and Secretions: Dealing with the Contaminated Airway in Trauma

Airway management in trauma patients can be particularly challenging due to the presence of contaminants such as vomitus, blood, and secretions in the airway. This review summarizes recent literature on managing airway contamination during the resuscitation of critically ill trauma patients.

The fundamental skill of suctioning the airway clear for oxygenation, ventilation and laryngoscopy remains paramount. There are a variety of commercially available suction catheters and devices well-suited to managing airway contamination. Recently, Suction Assisted Laryngoscopy and Airway Decontamination (SALAD) has emerged as technique for the management of airway contamination. Numerous simulation studies and case reports support the technique’s use.

Airway contamination should be anticipated during emergent airway management in trauma patients. Awareness of novel techniques and equipment may confer advantages when managing contaminated airway in trauma.