NASOTRACHEAL INTUBATION WITHOUT FORCEPS
No Forceps? No problem!
This innovative nasotracheal intubation technique was described by Jerry A. Dorsch and Susan E. Dorsch (2008) in the book, Understanding Anesthesia Equipment.
TECHNIQUE
Assess the nostrils for patency.
Apply a topical anesthetic to the nares.
Dilate the selected nostril with a nasal airway.
Insert the nasoendotracheal tube into the selected nostril in a gentle motion. Do not force the tube.
Once the nasoendotracheal tube meets the oropharynx, perform direct laryngoscopy.
Inflate the tracheal tube cuff with 10-15 ml of air; This causes the tip of the endotracheal cuff to align with the vocal cords.
Advance the endotracheal tube until the cuff comes in contact with the vocal cords.
Deflate the cuff.
Advance the tube past the vocal cords.
Inflate cuff and confirm placement.