The charts of 1798 consecutive admissions at this level one trauma center to evaluate the practice of emergency airway control were reviewed. A total of 335 patients required endotracheal intubation, 320 oral endotracheal, 12 nasotracheal, and three surgical. A technique of rapid sequence induction (RSI) with oral endotracheal intubation was the method of airway control in 260 spontaneously breathing patients. Prior cervical spine evaluation was not obtained. In all instances airway control was prompt and accurate. There were no hemodynamic nor neurologic complications secondary to RSI or oral endotracheal intubation. It is believed that RSI with oral endotracheal intubation is a reasonable alternative to nasotracheal intubation in the spontaneously breathing patient.