Indications for Intubation

Indications for Intubation
Intubation is reserved for those patients who continue to show signs of inadequate
respiration after basic interventions or those in whom these interventions
alone are not likely to sustain appropriate respiration (12).

Absolute Indications for Intubation:
1. Airway obstruction unrelieved with basic interventions,
2. Apnea or near apnea,
3. Respiratory distress, and
4. Severe neurologic deficit or decreased consciousness (i.e., focal deficit
or GCS rating less than 9) due to head trauma or any other cause.

Urgent Indications for Intubation:
1. Penetrating neck injury (with any signs of airway compromise or
expanding hematoma),
2. Persistent or refractory hypotension, especially due to active hemorrhage,
3. Chest wall injury with respiratory dysfunction, and
4. Moderate altered mentation, especially after head trauma, including
both combative and mildly obtunded patients.

Relative Indications for Nonemergent Intubation:
1. Oromaxillofacial injury,
2. Impending respiratory failure,
3. Need for diagnostic or therapeutic procedures [e.g., computed tomography
(CT) or angiography] in patients with risk for deterioration or
those unable to remain motionless during the examination, and
4. Potential respiratory failure after sedative-analgesic use.

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