What are the contraindications for Nasotracheal intubation?
By Sarah Smith
What are the contraindications for Nasotracheal intubation?
Contraindications to nasotracheal intubation include coagulopathy, maxillofacial trauma, CSF leak, and basilar skull fracture.
What is needed for Nasotracheal intubation?
Equipment required for nasotracheal intubation includes the following: Endotracheal tube – Nasal RAE (Ring-Adair-Elwyn) tube (see the first image below) or regular endotracheal tube. Lidocaine jelly or any other water-soluble lubricant. Magill forceps (see the second image below)
What is Nasotracheal intubation?
Nasotracheal intubation (NTI) involves passing an endotracheal tube through the naris, into the nasopharynx, and the trachea, most commonly after induction of general anesthesia in the operating room.
What is fiber optic intubation?
Fiberoptic intubation (FOI) is an effective technique for establishing airway access in patients with both anticipated and unanticipated difficult airways. First described in the late 1960s, this approach can facilitate airway management in a variety of clinical scenarios given proper patient preparation and technique.
What are the contraindications to nasal and nasopharyngeal suction?
Epiglottitis or croup are considered absolute contraindications to nasotracheal suctioning. Other situations, while not absolutely contraindicated, that need to be taken into consideration include: head or neck injury, laryngospasm and bronchospasm, occluded nasal passages, and bleeding disorders.
When is fiberoptic intubation used?
Fiberoptic intubation is the method of choice in all cases of anticipated difficult airway. It combines direct vision with flexibility to view the pharynx when direct laryngoscopy is considered difficult or impossible.
How do you do nasal fiberoptic intubation?
The applicators are gently inserted into each nostril and gently advanced until they reach the posterior wall of the nasopharynx. Alternatively, the solution can be dripped in using a 20 gauge intravenous catheter or sprayed using an atomizer. It is advisable to prepare both nares.
