Blind digital intubation

(Redirected from 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 introdution 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

  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

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.