Airway management in the prehospital environment is difficult just by virtue of where we are doing it and the lack of resources available to help us manage the difficulties. Add to that a patient with mangled facial anatomy or is dangerously peri-arrest due to hemorrhage and the danger can seem insurmountable.

What the research tells us is that there are really three big buckets of problems in airway management that contribute to morbidity and mortality: hypoxia, hypotension and multiple intubation attempts; this is the stuff that airway nightmares are made of.

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