Discuss intubation strategy with senior anaesthetic colleagues (consider single or double cuffed tubes, use of fibre optics).

Consider additional large bore chest drain on the affected side (one intercostal space further up). Do not attach suction to the chest drain.

Other significant patient injuries may influence your resuscitation strategy.

Learning bite

Two large bore chest drains may be needed to counter the air leak of a tracheo-bronchial injury.