Question: What are the indications for tracheal intubation in trauma patients?

Answer: The indications are:

• Airway obstruction unrelieved by basic airway manoeuvres
• Impending airway obstruction e.g. facial burns and inhalational injury or neck haematoma
• Reduced conscious level: Glasgow coma score (GCS) <9 or not responding to voice. An unprotected airway is at risk of aspiration of stomach contents, blood and secretions. In head injury a secure airway allows both oxygenation and control of CO₂ to prevent secondary brain injury
• Respiratory failure, e.g. chest injuries impairing ventilation or oxygenation, reduced respiratory drive due to head injuries
• Need for emergency resuscitative surgery
• Combative patients needing further assessment

This assumes you have neurosurgery or CT scanning, ventilators, full monitoring and sedative infusions available. The risks and benefits of intubation may be different if resources are limited.