UMEM Educational Pearls

Title: Intubating head injured patients

Category: Trauma

Keywords: brain injury, intubation, best practice, hypoxia, hypotension (PubMed Search)

Posted: 9/6/2025 by Robert Flint, MD (Updated: 9/7/2025)
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These authors reiterate principles that have been discussed previously regarding intubation in head/brain injured patients.

-Avoid hypoxia with preoxygenation

-Avoid hypotension by fluid resuscitation/vasopressors/blood in the correct clinical setting

-Use hemodynamically neutral induction agents such as Etomidate or Ketamine (it is ok use this in head injured patients!)

-Video laryngoscope gives best first pass success which minimizes hypoxia/raised ICP

-Post-Intubation aim for eucapnia (avoid hyperventilation)

-Use adequate post-intubation sedation to avoid raised ICP