Laurensia Vidya Ayuningtyas1, Airi Mutiar2, Prananda Surya Airlangga1,2

1Faculty of Medicine, Airlangga University, Surabaya, Indonesia
2Department of Anesthesiology and Intensive Care, Dr. Soetomo General Hospital, Surabaya, Indonesia

Keywords: Airway management, awake intubation, emergency room intubation, face-to-face intubation, maxillofacial injuries


Maxillofacial injury may cause difficulty during airway assessment and management in the emergency setting. Alternative intubation positions and techniques should be considered to ensure patient safety. A 37-year-old male patient arrived at the emergency department with a degloving maxillofacial injury after a high-impact motor vehicle accident. Active bleeding from his wounds prevented him from lying supine and raised concerns of aspiration, requiring immediate securing of the airway. Since the patient was alert and cooperative, awake face-to-face intubation in the upright position was performed. Intubation was successful on the first attempt without any complications using a video laryngoscope with topical anesthesia sprayed intraorally. Awake intubation in the face-to-face upright position can be successful in a cooperative patient with severe maxillofacial trauma.

How to cite this article: Ayuningtyas LV, Mutiar A, Airlangga PS. Face-to-face awake intubation in an upright position in severe maxillofacial trauma. Turk J Emerg Med 2024;24(1):58-61.

Author Contributions

LVA: data curation (lead); writing of original draft (lead); visualization (equal); review and editing (equal). AM: conceptualization (lead); visualization (equal); review and editing (equal). PSA: supervision (lead); review and editing (supporting). All authors have read and approved the content of the final manuscript.

Conflict of Interest

None declared.

Financial Disclosure