Your Patient Is a 45-Year-Old Man with Extensive Blunt Trauma

Your patient is a 45-year-old man with extensive blunt trauma to the face. He has decorticate posturing in response to pain; weak, irregular respiratory effort at 6 per minute; and a heart rate of 50 with a good radial pulse. The patient appears to have nasal and mandibular fractures, and an oropharyngeal airway is insufficient to keep the tongue from the posterior pharynx. Which of the following has the most potential to negatively impact the patient?

A) Retrograde intubation
B) Oral intubation under direct laryngoscopy
C) Nasotracheal intubation
D) A non-visualized dual-lumen airway