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Techniques for Oral Intubation

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Techniques for Nasal Intubation
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Techniques for Nasal Intubation

All oral intubation techniques require opening the mouth, retracting or navigating around the tongue, and placement of an endotracheal tube. Except for intubation by digital palpation, or blind intubation through a supraglottic airway, all methods of orotracheal intubation involve a direct or indirect means of visualizing the larynx.

 

The traditional method of oral intubation, first publicized by Kirstein in 1895, and still the most commonly used emergency airway management technique, is direct laryngoscopy. A rigid laryngoscope blade (curved or straight) retracts the tongue and epiglottis, and exposes the patient’s larynx to a direct line of sight from the operator’s dominant pupil. Direct laryngoscopy is amongst the most effective procedures in clinical medicine; it works in more than 99% of cases. A small percentage of patients have a “difficult airway, or “difficult intubation,” which is a term commonly used to mean poor laryngeal visualization, need for repeat laryngoscope insertions, or problems passing a tracheal tube. “Difficult intubation” or “difficult laryngoscopy” is not only a function of the patient and their relevant airway anatomy. The procedure depends upon laryngoscope handling, how the blade tip interacts with perilaryngeal structures, and the operator’s ability to identify partially seen laryngeal landmarks, and then intubate a partially exposed larynx. In short, the operator is a significant variable in direct laryngoscopy as well as other methods of intubation. Intubation deices that use video cameras, fiberoptics, or other optical systems to visualize the larynx are increasing used in elective and emergency airway management. Each device has its own subtleties of use With many of these intubation devices the potentially difficult aspect of intubation becomes tube delivery, not target visualization.

 

Click on images below to learn more about a specific oral intubation technique:

direct laryngoscopy video laryngoscopy optical laryngoscopy

Direct Laryngoscopy

 

Video Laryngoscope

Optical Laryngoscope

  Flexible Fiberoptic Intubation   Optical Stylet   Digital Intubation

Flexible Fiberoptic Intubation

 

Optical Stylet

Digital Intubation

  Fastrach LMA Intubation    

Fastrach LMA Intubation

   

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DISCLAIMER:  The procedures discussed at this website, to be performed properly, rely on complex medical skills and should only be undertaken after formal instruction and hands-on clinical training with appropriate supervision, and after receiving professional certification and authorization to do so. The content presented herein is meant to serve as just one of many resources that trainees and health care professionals should consult in the course of the their skill acquisition and ongoing practice. Airway Cam Technologies, Inc., its authors, officers, agents and assigns, disclaim any and all responsibility for any adverse outcomes and or harmful acts committed by others persons who may have consulted this website or relied on information contained herein.

 

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