Abstract
Airway management in trauma patients is a critical component of resuscitation, often complicated by the unique positioning required by the nature and location of injuries. Penetrating abdominal trauma requiring lateral positioning presents an uncommon and challenging scenario for airway stabilization, particularly when traditional supine approaches are contraindicated. We describe the case of an 18-year-old male patient who was taken to the operating theater with a penetrating abdominal injury necessitating lateral positioning due to ongoing bleeding and hemodynamic instability. Initial airway assessment revealed a compromised airway, hypoxia, and a risk of aspiration, necessitating rapid airway intervention in the lateral position. Using a video laryngoscope, a secure airway was successfully established while maintaining the patient's position. The lateral approach enabled optimal management of both the penetrating injury and airway compromise, preventing further exacerbation of the injury and reducing aspiration risks. This case highlights the challenges and considerations in managing airways in trauma patients who cannot tolerate supine positioning. It underscores the importance of adaptability in emergency airway techniques, the utility of advanced tools for visualization and intubation, and the value of multidisciplinary collaboration in managing complex trauma scenarios.