Airway Management in Patients With Severe Traumatic Brain Injuries in the Emergency Unit: Integratva Review

Abstract

Objective: The present study aims to analyze the best practices, risk factors, and challenges involved in airway management in patients with severe TBI, both in the prehospital and hospital settings, in order to identify interventions that optimize clinical outcomes. Method: An integrative literature review was conducted based on studies published between 2019 and 2024. The research was structured by the PICo (Population, Interest and Context) strategy, focusing on patients with severe TBI, airway management and ventilation. After screening 325 articles, 10 studies were selected for critical analysis, following the PRISMA guidelines. Results and Discussion: It was observed that early intubation, although crucial, presents significant variations in effectiveness depending on the training and experience of the team. Complications such as excessive hyperventilation, aspiration, and difficulties in airway management in patients with cervical spine injuries were recurrent in the studies. The implementation of standardized protocols and the use of advanced devices, such as videolaryngoscopy, have been identified as essential measures to reduce complications and improve outcomes. The need for a trained multidisciplinary team and the use of evidence-based guidelines was also highlighted as critical to treatment success. Conclusion: Airway management in patients with severe TBI is complex and requires a careful and well-trained approach. The review emphasizes the importance of well-defined protocols and continuous training of emergency responders to optimize survival and neurological outcomes for these patients.