Blind digital intubation: Difference between revisions
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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 | *Fell out of favor in 1907 with introduction of [[laryngoscopy]] | ||
==Indications== | ==Indications== | ||
| Line 19: | Line 19: | ||
*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>]] | ||
#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== | ==Complications== | ||
| Line 67: | Line 65: | ||
==External Links== | ==External Links== | ||
===Videos=== | |||
{{#widget:YouTube|id=WbQEJ52Qa-w}} | |||
==References== | ==References== | ||
<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
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}}