Skip to main content

Unconventional Intubation Techniques

  • Chapter
  • First Online:
The Airway Manual

Abstract

With the advent of Videolaryngoscopes and wider availability of Fiberoptic bronchoscopes, some of the unconventional techniques of endotracheal intubation are not very popular in modern anaesthesia. yet, these can be useful techniques in the resource limited settings and with personnel trained in these techniques. Retrograde intubation and blind nasal intubation described in this chapter could prove useful to anesthesiologists or other clinicians when conventional techniques are not feasible or fail. They are characterized by relative simplicity, less dependence on expensive airway devices, minimal patient discomfort, and low incidence of complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. King HK, Wang LF, Khan AK, Wooten DJ. Translaryngeal guided intubation for difficult intubation. Crit Care Med. 1987;15:869–71.

    Article  CAS  PubMed  Google Scholar 

  2. Dhara SS. Retrograde tracheal intubation. Anaesthesia. 2009;64:1094–104.

    Article  CAS  PubMed  Google Scholar 

  3. Burbulys D, Kiai K. Retrograde intubation. Emerg Med Clin North Am. 2008;26:1029–41.

    Article  PubMed  Google Scholar 

  4. Butler FS, Cirillo AA. Retrograde tracheal intubation. Anesth Analg. 1960;39:333–8.

    Article  CAS  PubMed  Google Scholar 

  5. Waters DJ. Guided blind endotracheal intubation: For patients with deformities of the upper airway. Anaesthesia. 1963;18:158–62.

    Article  CAS  PubMed  Google Scholar 

  6. McNamara RM. Retrograde intubation of the trachea. Ann Emerg Med. 1987;16:680–2.

    Article  CAS  PubMed  Google Scholar 

  7. Benumof JL. Management of the difficult adult airway. With special emphasis on awake tracheal intubation. Anesthesiology. 1991;75:1087–110.

    Article  CAS  PubMed  Google Scholar 

  8. Stern Y, Spitzer T. Retrograde intubation of the trachea. J Laryngol Otol. 1991;105(9):746–7.

    Article  CAS  PubMed  Google Scholar 

  9. Hung OR, al-Qatari M. Light-guided retrograde intubation. Can J Anaesth. 1997;44(8):877–82.

    Article  CAS  PubMed  Google Scholar 

  10. Benumof JL. The American Society of Anesthesiologists management of the difficult airway algorithm and explanation-analysis of the algorithm. In: Benumof JL, editor. Airway management: principles and practice. St Louis: C.V. Mosby; 1998. p. 151–3.

    Google Scholar 

  11. Practice guidelines for management of the difficult airway. An updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2003;98:1269–77.

    Google Scholar 

  12. Ovassapian A, Yelich SJ, Dykes MHM, Brunner EE. Fiberoptic nasotracheal intubation—incidence and cause of failure. Anesth Analg. 1983;62:692–5.

    Article  CAS  PubMed  Google Scholar 

  13. Weksler N, Klein M, Weksler D, et al. Retrograde tracheal intubation: beyond fibreoptic endotracheal intubation. Acta Anaesthesiol Scand. 2004;48(4):412–6.

    Article  CAS  PubMed  Google Scholar 

  14. Schwartz DE, Matthay MA, Cohen NH. Death and other complications of emergency airway management in critically ill adults. Anesthesiology. 1995;82:367–76.

    Article  CAS  PubMed  Google Scholar 

  15. Brenman S, Gupta S, Tseeng S. Successful retrograde intubation after failed fiberoptic intubation and percutaneous cricothyrotomy. J Emerg Med. 2017;53(4):550–3.

    Article  PubMed  Google Scholar 

  16. Barriot P, Riou B. Retrograde technique for tracheal intubation in trauma patients. Crit Care Med. 1988;16(7):712–3.

    Article  CAS  PubMed  Google Scholar 

  17. Gill M, Madden MJ, Green SM. Retrograde endotracheal intubation: an investigation of indications, complications, and patient outcomes. Am J Emerg Med. 2005;23(2):123–6.

    Article  PubMed  Google Scholar 

  18. Jain G, Singh DK, Yadav G, Gupta SK, Tharwani S. A modification in the tube guide to facilitate retrograde intubation: A prospective, randomised trial. Indian J Anaesth. 2011;55(5):499–503.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Lenfant F, Benkhadra M, Trouilloud P, Freysz M. Comparison of two techniques for retrograde tracheal intubation in human fresh cadavers. Anesthesiology. 2006;104:48–51.

    Article  PubMed  Google Scholar 

  20. Tüfek A, Uçan MC, Tokgöz O, Çelik F, Ağaçayak S. Evaluation of retrograde intubation in patients with limited mouth opening. J Anesth. 2013;27(4):631–2.

    Article  PubMed  Google Scholar 

  21. Slots P, Vegger PB, Bettger H, Reinstrup P. Retrograde intubation with a Mini-Trach II kit. Acta Anaesthesiol Scand. 2003;47(3):274–7.

    Article  CAS  PubMed  Google Scholar 

  22. Vieira D, Lages N, Dias J, Maria L, Correia C. Ultrasound-guided retrograde intubation. Anaesthesia. 2013;68:1075–6.

    Article  CAS  PubMed  Google Scholar 

  23. Vieira D, Lages N, Dias J, Maria L, Correia C. Retrograde intubation: An old new technique. Anaesthesia. 2013;68(10):1075–6.

    Article  CAS  PubMed  Google Scholar 

  24. Varshney PG, Kachru N. Fibreoptic-aided retrograde intubation: Is it useful to combine two techniques? Indian J Anaesth. 2011;55:546–7.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kristensen MS, McGuire B. Managing and securing the bleeding upper airway: a narrative review. Can J Anaesth. 2020;67(1):128–40.

    Article  PubMed  Google Scholar 

  26. Harris EA, Fischler KE. Does the site of anterior tracheal puncture affect the success rate of retrograde intubation? Br J Anaesth. 2013;110(6):1064–5.

    Article  CAS  PubMed  Google Scholar 

  27. Vithal K, et al. Retrograde intubation in temporomandibular joint ankylosis—a double guide wire technique. Indian J Anaesth. 2008;52(1):90–2.

    Google Scholar 

  28. Vadepally AK, Sinha R, Kumar AVSSS. Retrograde intubation through nasal route in patients with limited mouth opening undergoing oral and maxillofacial surgery. J Oral Biol Craniofac Res. 2018;8(1):30–4.

    Article  PubMed  Google Scholar 

  29. Ball DR, Stallard M. Retrograde tracheal intubation for bleeding and fragmenting airway tumours. Anaesthesia. 2014;69(2):182.

    Article  CAS  PubMed  Google Scholar 

  30. Ramsey CA, Dhaliwal SS. Retrograde and submental intubation. Atlas Oral Maxillofacial Surg Clin North Am. 2010;18:61–8.

    Article  Google Scholar 

  31. Arndt GA, Topp J, Hannah J, McDowell TS, Lesko A. Intubation via the LMA using a Cook retrograde intubation kit. Can J Anaesth. 1998;45:257–60.

    Article  CAS  PubMed  Google Scholar 

  32. Fichtner A, Vrtny P, Schaarschmidt F. Ultrasound-guided retrograde emergency intubation. Anaesthesist. 2015;64:948–52.

    Article  CAS  PubMed  Google Scholar 

  33. Green JS, Tsui BC. Application of ultrasonography in ENT: Airway assessment and nerve blockade. Anesthesiol Clin. 2010;28:541–53.

    Article  PubMed  Google Scholar 

  34. Dinsmore J, Heard AM, Green RJ. The use of ultrasound to guide time-critical cannula tracheotomy when anterior neck airway anatomy is unidentifiable. Eur J Anaesthesiol. 2011;28(7):506–10.

    Article  PubMed  Google Scholar 

  35. Lechman MJ, Donahoo JS, MacVaugh H III. Endotracheal intubation using percutaneous retrograde guidewire insertion followed by antegrade fiberoptic bronchoscopy. Crit Care Med. 1986;14:589–90.

    Article  CAS  PubMed  Google Scholar 

  36. Gupta B, McDonald JS, Brooks JHJ, Mendenhall J. Oral fiberoptic intubation over a retrograde guidewire. Anesth Analg. 1989;68:517–9.

    Article  CAS  PubMed  Google Scholar 

  37. Tobias R. Increased success with retrograde guide for endotracheal intubation. Anesth Analg. 1983;62:366–7.

    Article  CAS  PubMed  Google Scholar 

  38. Roberts KW, Solgonick RM. A modification of retrograde wire–guided fibreoptic assisted endotracheal Intubation in a patient with ankylosing spondylitis. Anesth Analg. 1996;82:1290–1.

    CAS  PubMed  Google Scholar 

  39. Bissinger U, Guggenberger H, Lenz G. Retrograde-guided fiberoptic intubation in patients with laryngeal carcinoma. Anesth Analg. 1995;81:408–10.

    CAS  PubMed  Google Scholar 

  40. Audenaert SM, Montgomery CL, Stone B. Retrograde-assisted fibreoptic tracheal intubation in children with difficult airways. Anesth Analg. 1991;73(5):660–4.

    Article  CAS  PubMed  Google Scholar 

  41. Eidelman LA, Pizov R. A safer approach to retrograde-guided fiberoptic intubation. Anesth Analg. 1996;82(5):1108.

    Article  CAS  PubMed  Google Scholar 

  42. Przybylo HJ, Stevenson GW, Vicari FA. Retrograde fibre optic intubation in a child with Nager’s syndrome. Can J Anaesth. 1996;43:697–9.

    Article  CAS  PubMed  Google Scholar 

  43. Rosenblatt WH, Angood PB, Maranets I. Retrograde fiberoptic intubation. Anesth Analg. 1997;84(5):1142–4.

    Article  CAS  PubMed  Google Scholar 

  44. Dhanyee AS, Pillai R, Sahajanandan R. Wire guided fibreoptic retrograde intubation in a case of glottic mass. Indian J Anaesth. 2016;60(3):219–21.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Harvey SC, Fishman RL, Edwards SM. Retrograde intubation through a laryngeal mask airway. Anesthesiology. 1996;85(6):1503–4.

    Article  CAS  PubMed  Google Scholar 

  46. Miner JR, Rubin J, Clark J, Reardon RF. Retrograde Intubation with an Extraglottic Device in Place. J Emerg Med. 2015;49(6):864–7.

    Article  PubMed  Google Scholar 

  47. Ciftci T, Erbatur S. Retrograde intubation via laryngeal mask airway in a paediatric patient with fallot-type ventricular septal defect and cleft palate deformity. Middle East J Anaesthesiol. 2016;23(4):479–82.

    PubMed  Google Scholar 

  48. Parmet J, Metz S. Retrograde endotracheal intubation: an underutilized tool for management of the difficult airway. Contemp Surg. 1996;49(5):300–6.

    Google Scholar 

  49. Wijesinghe H, Gough J. Complications of a retrograde intubation in a trauma patient. Acad Emerg Med. 2000;7(11):1267–71.

    Article  CAS  PubMed  Google Scholar 

  50. Bowes WA, Johnson JO. Pneumomediastinum after planned retrograde fiberoptic intubation. Anesth Analg. 1994;78:795–7.

    Article  PubMed  Google Scholar 

  51. Beebe DS, Tran P, Belani KG, Adams GL. Pretracheal abscess following retrograde tracheal intubation [Letter]. Anaesthesia. 1995;50(5):470.

    Article  CAS  PubMed  Google Scholar 

  52. Akinyemi O. Complications of guided blind endotracheal intubation. Anesthesia. 1979;34:590–2.

    Article  CAS  Google Scholar 

  53. Contrucci RB, Gottlieb JS. A complication of retrograde endotracheal intubation [Letter]. Ear Nose Throat J. 1990;69(11):776–8.

    CAS  PubMed  Google Scholar 

  54. Loh KS, Irish JC. Traumatic complications of intubation and other airway management procedures. Anesthesiol Clin North Am. 2002;20(4):953–69.

    Article  PubMed  Google Scholar 

  55. Claffey LP, Phelan DM. A complication of cricothyroid ‘minitracheostomy’ ± oesophagal perforation. Intensive Care Med. 1989;15:140–1.

    Article  CAS  PubMed  Google Scholar 

  56. Ratnayake B, Langford RM. A survey of emergency airway management in the United Kingdom. Anaesthesia. 1996;51:908–11.

    Article  CAS  PubMed  Google Scholar 

  57. Van Stralen DW, Rogers M, Perkin RM, Fea S. Retrograde intubation training using a mannequin. Am J Emerg Med. 1995;13(1):50–2.

    Article  PubMed  Google Scholar 

  58. Powell WF, Ozdil T. A translaryngeal guide for tracheal intubation. Anesth Analg. 1967;46:231–4.

    Article  CAS  PubMed  Google Scholar 

  59. Harmer M, Vaughan RS. Guided blind oral intubation. Anaesthesia. 1980;35:921.

    Article  CAS  PubMed  Google Scholar 

  60. Borland LM, Swan DM, Leff S. Difficult pediatric intubation: a new approach to the retrograde technique. Anesthesiology. 1981;55:577–8.

    Article  CAS  PubMed  Google Scholar 

  61. Mounir N, Madi A, Trop D. Pulling versus guiding: a modification of retrograde guided intubation. Can J Anaesth. 1989;36:336–9.

    Article  Google Scholar 

  62. Mahajan R, Sandhya X, Chari P. An alternative technique for retrograde intubation (correspondence). Anaesthesia. 2001;56:1207–8.

    CAS  PubMed  Google Scholar 

  63. Arya VK, Dutta A, Chari P. Diffcult retrograde endotracheal intubation: the utility of a pharyngeal loop. Anesth Analg. 2002;94:470–3.

    Article  PubMed  Google Scholar 

  64. Marciniak D, Smith CE. Emergent retrograde tracheal intubation with a gum-elastic Bougie in a trauma patient. Anesth Analg. 2007;105:1720–1.

    Article  PubMed  Google Scholar 

  65. Sanchez A. Retrograde intubation techniques. In: Hagberg CA, editor. Benumof’s airway management: principles and practice. 3rd ed. Philadelphia: Saunders; 2013. p. 419–26.

    Google Scholar 

  66. Sriramka B, Mallik D, Khetan M, Moda N. Revisiting the awake retrograde nasal intubation technique. J Dent Anesth Pain Med. 2018;18(5):315–7.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Gerenstein RI, Arria-Devoe G. Jwire and translaryngeal guided intubation. Crit Care Med. 1989;17:486.

    Article  CAS  PubMed  Google Scholar 

  68. Gerenstein RI. J-wire facilitates translaryngeal guided intubation. Anesthesiology. 1992;76:1059.

    Article  CAS  PubMed  Google Scholar 

  69. Xue FS, Li QX. Retrograde intubation techniques. In: Xue FS, editor. Modern airway management: a key technique for clinical anesthesia and critical care medicine. Zheng-Zhou: Zheng-Zhou University Publishing House; 2002. p. 474–89.

    Google Scholar 

  70. Bourke D, Levesque PR. Modification of retrograde guide for endotracheal intubation. Anesth Analg. 1974;53:1013–104.

    Article  CAS  PubMed  Google Scholar 

  71. Abou-Madi MN, Trop D. Pulling versus guiding: a modification of retrograde guided intubation. Can J Anaesth. 1989;36:336–9.

    Article  CAS  PubMed  Google Scholar 

  72. Hines MH, Meredith JW. Modified retrograde intubation technique for rapid airway access. Am J Surg. 1990;159:597–9.

    Article  CAS  PubMed  Google Scholar 

  73. Kuhn F. Die pernasale tubage. München Med Wochenschr. 1902;49:1456.

    Google Scholar 

  74. Rowbotham ES, Magill I. Anaesthetics in the plastic surgery of the face and jaws. Proc R Soc Med. 1921;14:17–27.

    PubMed  PubMed Central  Google Scholar 

  75. Chauhan V, Acharya G. Nasal intubation: A comprehensive review. Indian J Crit Care Med. 2016;20(11):662–7.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Rowbotham S. Intratracheal anaesthesia by the nasal route for operations on the mouth and lips. Br Med J. 1920;2:590.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Magill IW. Technique in endotracheal anaesthesia. Br Med J. 1930;2:817.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Magill IW. Endotracheal anaesthesia. Am J Surg. 1936;34:450–5.

    Article  Google Scholar 

  79. Hung O, Zhang J, Lamb A, Hung C, Hung D, Stewart R. Teaching blind nasal intubation in Rwanda. Can J Anaesth. 2015;62(5):553–4.

    Article  PubMed  Google Scholar 

  80. Harris RD, Gillett MJ, Joseph AP, Vinen JD. An aid to blind nasal intubation. J Emerg Med. 1998;16(1):93–5.

    Article  CAS  PubMed  Google Scholar 

  81. Collins PD, Godkin RA. Awake blind nasal intubation—a dying art? Anaesth Intensive Care. 1992;20(2):225–7.

    Article  CAS  PubMed  Google Scholar 

  82. Dubey PK, Dubey P, Kumar N, Bhardwaj G, Kumar N. Blind nasal intubation revisited: no longer a blind technique? J Emerg Med. 2017;52(2):231–4.

    Article  PubMed  Google Scholar 

  83. Wilkinson DJ. Providing quality in anesthesia care in low- and middle-income countries. Can J Anaesth. 2014;61:975–8.

    Article  PubMed  Google Scholar 

  84. Kuduvalli PM, Jervis A, Tighe SQ, Robin NM. Unanticipated difficult airway management in anaesthetised patients: a prospective study of the effect of mannequin training on management strategies and skill retention. Anaesthesia. 2008;63:364–9.

    Article  CAS  PubMed  Google Scholar 

  85. Shapiro H, Unger R. Blind, but not deaf or dirty, intubations. Anesthesiology. 1986;64(2):297.

    Article  CAS  PubMed  Google Scholar 

  86. Kumar R, Gupta E, Kumar S, Rani Sharma K, Rani GN. Cuff inflation-supplemented laryngoscope-guided nasal intubation: a comparison of three endotracheal tubes. Anesth Analg. 2013;116(3):619–24.

    Article  PubMed  Google Scholar 

  87. Gorback MS. Inflation of the endotracheal tube cuff as an aid to blind nasal endotracheal intubation. Anesth Analg. 1987;66:916–7.

    Article  CAS  PubMed  Google Scholar 

  88. van Elstraete AC, Pennant JH, Gajraj NM, Victory RA. Tracheal tube cuff inflation as an aid to blind nasotracheal intubation. Br J Anaesth. 1993;70:691–3.

    Article  PubMed  Google Scholar 

  89. Omoigui S, Glass P, Martel DL, Watkins K, Williams KL, Whitefield SM, Wooten LL. Blind nasal intubation with audio-capnometry. Anesth Analg. 1991;72(3):392–3.

    Article  CAS  PubMed  Google Scholar 

  90. Zhang J, Lamb A, Hung O, Hung C, Hung D. Blind nasal intubation: teaching a dying art. Can J Anaesth. 2014;61(11):1055–6.

    Article  PubMed  Google Scholar 

  91. Dyson A, Saunders PR, Giesecke AH. Awake blind nasal intubation: use of a simple whistle. Anaesthesia. 1990;45:71–2.

    Article  CAS  PubMed  Google Scholar 

  92. Cook RT Jr, Stene JK Jr. The BAAM and endotrol endotracheal tube for blind oral intubation. Beck Airway Air Flow Monitor. J Clin Anesth. 1993;5:431–2.

    Article  PubMed  Google Scholar 

  93. Hamill M, Toung T. Blind nasotracheal intubations revisited. Anesth Analg. 1994;79:390–1.

    Article  CAS  PubMed  Google Scholar 

  94. Nofal O. Awake light-aided blind nasal intubation: prototype device. Br J Anaesth. 2010;104(2):254–9.

    Article  CAS  PubMed  Google Scholar 

  95. Iseki K, Murakawa M, Tase C, Otsuki M. Use of a modified lightwand for nasal intubation. Anesthesiology. 1999;90:635.

    Article  CAS  PubMed  Google Scholar 

  96. Dong Y, Li G, WuW SR, Shao Y. Lightwand-guided nasotracheal intubation in oromaxillofacial surgery patients with anticipated difficult airways: a comparison with blind nasal intubation. Int J Oral Maxillofac Surg. 2013;42:1049–53.

    Article  CAS  PubMed  Google Scholar 

  97. Trikha A, Singh C, Rewari V, Arora MK. Evaluation of the SCOTI device for confirming blind nasal intubation. Anaesthesia. 1999;54(4):347–9.

    Article  CAS  PubMed  Google Scholar 

  98. Murray D, Ward ME, Sear JW. SCOTI—a new device for identification of tracheal intubation. Anaesthesia. 1995;50:1062–4.

    Article  CAS  PubMed  Google Scholar 

  99. Haridas RP, Chesshire KJ, Rocke DA. An evaluation of SCOTI device. Anaesthesia. 1997;52:453–6.

    Article  CAS  PubMed  Google Scholar 

  100. Dubey PK, Akhileshwar. Ultrasound-guided blind nasal intubation in a patient with massive oral tumor. Paediatr Anaesth. 2018;28(3):300–1.

    Article  PubMed  Google Scholar 

  101. Elwood T, Stillions DM, Woo DW, Bradford HM, Ramamoorthy C. Nasotracheal intubation: a randomized trial of two methods. Anesthesiology. 2002;96(1):51–3.

    Article  PubMed  Google Scholar 

  102. Lim CW, Min SW, Kim CS, Chang JE, Park JE, Hwang JY. The use of a nasogastric tube to facilitate nasotracheal intubation: a randomised controlled trial. Anaesthesia. 2014;69(6):591–7.

    Article  PubMed  Google Scholar 

  103. Sugiura N, Miyake T, Okui K, Hibi G, Oka T, Yamada M, Arai T. Increased success of blind nasotracheal intubation through the use of nasogastric tubes as a guide. Anesth Prog. 1996;43(2):58–60.

    CAS  PubMed  PubMed Central  Google Scholar 

  104. Enk D, Palmes AM, Van Aken H, Westphal M. Nasotracheal intubation: a simple and effective technique to reduce nasopharyngeal trauma and tube contamination. Anesth Analg. 2002;95(5):1432–6.

    Article  PubMed  Google Scholar 

  105. Dhasmana SC. Nasotracheal fiberoptic intubation: patient comfort, intubating conditions and hemodynamic stability during conscious sedation with different doses of dexmedetomidine. J Maxillofac Oral Surg. 2014;13(1):53–8.

    Article  PubMed  Google Scholar 

  106. Thongrong C, Thaisiam P, Kasemsiri P. Validation of simple methods to select a suitable nostril for nasotracheal intubation. Anesthesiol Res Pract. 2018;2018:4910653.

    PubMed  PubMed Central  Google Scholar 

  107. Dauphinee K. Nasotracheal intubation. Emerg Med Clin North Am. 1988;6(4):715–23.

    Article  CAS  PubMed  Google Scholar 

  108. Juergens AL 2nd, Odom BW, Ren CE, Meyers KE. Success rates with digital intubation: comparing unassisted, stylet, and gum-elastic Bougie techniques. Wilderness Environ Med. 2019;30(1):52–5.

    Article  PubMed  Google Scholar 

  109. Hardwick WC, Bluhm D. Digital intubation. J Emerg Med. 1984;1(4):317–20.

    Article  CAS  PubMed  Google Scholar 

  110. Shiber JR, Fontane E. Digital tracheal intubation: an effective technique that should not be forgotten. Am J Emerg Med. 2007;25(6):726.

    Article  PubMed  Google Scholar 

  111. Vesalius A. De Humani Corporis Fabrica. Basil, Switzerland, lS43:658. Located at: History and Special Collection Division, Louise M. Darling Biomedical Library. University of California at Los Angeles; 1543.

    Google Scholar 

  112. Young SE, Miller MA, Crystal CS, Skinner C, Coon TP. Is digital intubation an option for emergency physicians in definitive airway management? Am J Emerg Med. 2006;24(6):729–32.

    Article  PubMed  Google Scholar 

  113. Cook RT Jr. Digital endotracheal intubation. Am J Emerg Med. 1992;10(4):396.

    Article  PubMed  Google Scholar 

  114. Stewart RD. Tactile orotracheal intubation. Ann Emerg Med. 1984;13(3):175–8.

    Article  CAS  PubMed  Google Scholar 

  115. Hsieh PS, Ma HP, Wong CS, Ong JR. Emergency tracheal intubation in an ankylosing spondylitis patient in a sitting position using an airway scope combined with face-to-face and digital intubation. J Emerg Med. 2018;54(5):674–7.

    Article  PubMed  Google Scholar 

  116. 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):397–9.

    PubMed  Google Scholar 

  117. Moura JH, da Silva GA. Neonatal laryngoscope intubation and the digital method: a randomized controlled trial. J Pediatr. 2006;148(6):840–1.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ramkiran, S., Bidkar, P.U. (2023). Unconventional Intubation Techniques. In: Ubaradka, R.S., Gupta, N., Bidkar, P.U., Tripathy, D.K., Gupta, A. (eds) The Airway Manual. Springer, Singapore. https://doi.org/10.1007/978-981-19-4747-6_22

Download citation

  • DOI: https://doi.org/10.1007/978-981-19-4747-6_22

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-4746-9

  • Online ISBN: 978-981-19-4747-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics