Blind digital intubation: Difference between revisions

(Created page with "==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 int...")
 
 
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==Overview==
==Overview==
*First introduced in 1880 when William MacEwan administered anesthesia through a metal tube inserted into the trachea by touch
*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 introdution of laryngoscopy
*Fell out of favor in 1907 with introduction of [[laryngoscopy]]


==Indications==
==Indications==
*Can be considered in any patient requiring endotracheal intubation
*Can be considered in any patient requiring [[Intubation|endotracheal intubation]]
*Can be used as a rescue method when traditional laryngoscopy fails
*Can be used as a rescue method when traditional [[Direct laryngoscopy|laryngoscopy]] fails
*Especially useful in:
*Especially useful in:
**Austere environments where laryngoscopy is not accessible
**Austere environments where laryngoscopy is not accessible
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*Disposable gloves
*Disposable gloves
*Endotracheal tube
*Endotracheal tube
*Can consider [[bougie]]-assisted technique <ref>Rich JM. Successful blind digital intubation with a bougie introducer in a patient with an unexpected difficult airway. Proc (Bayl Univ Med Cent). 2008;21(4):397-399. doi:10.1080/08998280.2008.11928436</ref>


==Procedure==
==Procedure==
1. Insert the index and middle fingers of the nondominant hand into the oral cavity
[[File:digitalintubation.png|thumb|<ref>Hardwick WC, Bluhm D. Digital intubation. Journal of Emergency Medicine 1984; 1: 317– 20.</ref>]]
2. Trace volar surface of fingers over dorsal surface of the tongue
#Insert the index and middle fingers of the nondominant hand into the oral cavity
3. Palpate and lift epiglottis
#Trace volar surface of fingers over dorsal surface of the tongue
4. Insert ETT with dominant hand
#Palpate and lift epiglottis
5. Lifting epiglottis with index finger, use middle finger to guide tube through vocal cords.
#Insert ETT with dominant hand
#Lifting epiglottis with index finger, use middle finger to guide tube through vocal cords.


==Complications==
==Complications==
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==See Also==
==See Also==
 
===Airway Pages===
*Pre-intubation
**[[Predicting the difficult airway]]
**[[Bag valve mask ventilation]]
**[[Apneic oxygenation]]
***[[EBQ:ED Preoxygenation]]
*Induction
**[[Critical care quick reference]]
**[[Rapid sequence intubation]]
**[[Delayed sequence intubation]]
*[[Intubation]]
**[[Intubation (peds)]]
**[[Direct laryngoscopy]]
**[[Video Laryngoscopy]]
**[[Bougie]]
**[[The difficult airway]]
**[[Advanced airway adjuncts]]
***[[Supraglottic airway]]
**Non-traditional intubation
***[[Awake intubation]]
***[[Nasal intubation]]
***[[Blind Digital Intubation]]
*[[Surgical airways]]
**[[Surgical cricothyrotomy]]
**[[Needle cricothyrotomy]]
**[[Pediatric jet ventilation]]
*Post-intubation
**[[Mechanical ventilation (main)]]
**[[Deterioration after intubation]] (DOPE)


==External Links==
==External Links==


===Videos===
{{#widget:YouTube|id=WbQEJ52Qa-w}}


==References==
==References==
1. Hardwick WC, Bluhm D. Digital intubation. Journal of Emergency Medicine 1984; 1: 317– 20.
 
<references/>
<references/>


[[Category:Procedures]]
[[Category:Procedures]]
[[Category:Critical Care]]

Latest revision as of 09:36, 3 January 2022

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

  • Disposable gloves
  • Endotracheal tube
  • Can consider bougie-assisted technique [1]

Procedure

[2]
  1. Insert the index and middle fingers of the nondominant hand into the oral cavity
  2. Trace volar surface of fingers over dorsal surface of the tongue
  3. Palpate and lift epiglottis
  4. Insert ETT with dominant hand
  5. 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

External Links

Videos

{{#widget:YouTube|id=WbQEJ52Qa-w}}

References

  1. ↑ Rich JM. Successful blind digital intubation with a bougie introducer in a patient with an unexpected difficult airway. Proc (Bayl Univ Med Cent). 2008;21(4):397-399. doi:10.1080/08998280.2008.11928436
  2. ↑ Hardwick WC, Bluhm D. Digital intubation. Journal of Emergency Medicine 1984; 1: 317– 20.
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