Blind digital intubation
Overview
- First introduced in 1880 when William MacEwan administered anesthesia through a metal tube inserted into the trachea by touch
- Fell out of favor in 1907 with introduction of laryngoscopy
Indications
- Can be considered in any patient requiring endotracheal intubation
- Can be used as a rescue method when traditional laryngoscopy fails
- Especially useful in:
- Austere environments where laryngoscopy is not accessible
- Out-of-hospital situations where patient is in confined space and cannot be extricated
- Copious secretions, blood or vomitus obscuring visualization of airway
- Cervical-spine precautions
- Grade III/IV Cormack-Lehane view with laryngoscopy
Contraindications
- Severe facial trauma prohibiting endotracheal intubation via the oropharyngeal route
Equipment Needed
Procedure
- Insert the index and middle fingers of the nondominant hand into the oral cavity
- Trace volar surface of fingers over dorsal surface of the tongue
- Palpate and lift epiglottis
- Insert ETT with dominant hand
- Lifting epiglottis with index finger, use middle finger to guide tube through vocal cords.
Complications
- Trauma to provider from patient's teeth
See Also
Airway Pages
- Pre-intubation
- Induction
- Intubation
- Surgical airways
- Post-intubation
External Links
Videos
{{#widget:YouTube|id=WbQEJ52Qa-w}}