 In the trauma setting, if a patient has arrived in the trauma bay with an ETCKing LT-D in place, it has traditionally been immediately exchanged out for an ETT upon arrival. The timing of the exchange has never been adequately defined in terms of safety. This study is a prospective clinical trial designed to evaluate the safety of supralaryngeal, ETCKing LT-D tube, exchange either in the operating room if immediate surgery is required or after stabilization in the trauma bayintensive care unit according to the protocol adapted previously by UWHC. 