Short Answer 
Immediate intubation may be necessary for patients with severe facial injuries, confusion, and intoxication due to risks of airway compromise and aspiration. Assessment of vital signs and preparation with appropriate equipment is crucial for effective airway management in these emergency situations.
Step 1: Assess the Patient’s Condition
Evaluate the patient’s overall condition, focusing on key indicators such as facial injuries, confusion, and alcohol intoxication. These factors significantly increase the risk of airway compromise. Pay attention to vital signs, especially pulse oximetry, which should indicate oxygen saturation levels; a reading of 94% or lower signals that immediate intervention is necessary.
Step 2: Identify Risks of Airway Compromise
Recognize the potential complications stemming from the combination of severe facial injuries and intoxication. The risks include swelling or blood obstructing the airway, particularly due to trauma. Furthermore, confusion from alcohol can hinder the patient’s cooperation with treatment, making it critical to address any airway issues promptly to avoid hypoxia and aspiration.
Step 3: Prepare for Intubation
Before proceeding with intubation, ensure that appropriate equipment and trained assistance are readily available. This preparation is crucial in a trauma situation where time and safety are paramount. Develop a plan for airway management that includes assessing the situation continuously, as well as ensuring that the team is ready to act quickly to secure the airway and protect against further complications.