Name: ACA- Hung 4e- Blind Nasal Intubation

Description: ACA- Hung 4e- Blind Nasal Intubation

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Upload Date: 2023-11-24T00:00:00.0000000

Transcript: Language: EN.
Segment:0 .
Although blind nasal intubation is seldom the technique of choice for tracheal intubation, it has proved lifesaving in many difficult airway situations.
Segment:1 Equipment.
Apart from endotracheal tube, no other equipment is needed for blind nasal intubation. However, as blind nasal intubation is often performed in a difficult airway situation, rescue airway equipment, such as INAUDIBLE devices and surgical airway kits should be readily available.
Segment:2 Preparation.
The endotracheal tube should be checked and the cuff completely deflated. The tube should be well lubricated. If time permits, softening of the tube by immersing it in warm saline and application of a vasoconstrictor to the nostrils may help to minimize the risk of bleeding.
Segment:3 Technique.
Maintenance of spontaneous ventilation is necessary to perform blind nasal intubation.
The patient's head and neck should be placed in a sniffing position. Insert the endotracheal tube into the nostril, gently advance the tube. And if resistance is met, do not use excessive force. The practitioner should consider switching to the alternative nostril. Listen for breath sounds as the tube advances to the glottis. As shown in this video, a gentle jaw lift or jaw thrust may help to elevate the epiglottis and facilitate tracheal intubation.
In the event that esophageal intubation occurs repeatedly, the tip of the tube is withdrawn to the hypopharynx and inflation of 20 cc of air into the cuff of the tube will help to elevate the tip anteriorly toward the glottic opening. Alternatively, a directional tip endotracheal tube, such as the Endotrol tube, can be used, since the curve of the tube can be controlled by a wire hook.
Correct tracheal tube placement should be confirmed by end tidal CO2 and auscultation.
Segment:4 Trouble Shooting.
It is sometimes not easy to listen to the breath sounds during nasal intubation. The BAAM whistle may provide an auditory to and flow whistle to facilitate nasotracheal intubation. If spontaneous ventilation is not available, the tip of the tube can be guided by using a light wand device, such as the Trachlight, as shown in this video.
Segment:5 Summary.
While blind nasal intubation may not be the technique of choice for tracheal intubation in most situations, it remains a useful technique, particularly in some difficult emergency situations. Maintenance of spontaneous ventilation is generally required for blind nasal intubation. The experience and skill of the practitioner are key determinants for success with this technique.

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