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Capnography-Assisted Nasotracheal Intubation Using Cuff Inflation and Gum-Elastic-Bougie

      Blind nasal intubation (BNI) is a time-tested technique for management of patients with difficult intubation. Fiberoptic intubation is the gold standard; however, in situations like trauma when there is blood inside the airway, fiberoptic intubation is usually not possible. BNI is useful in such similar situations and that's why it is still a part of the difficult airway algorithm. Many techniques have been used to improve the success rate of BNI, with each technique having its own merits and demerits (
      • Sharma R.
      • Kumar R.
      • Kumar S.
      • Gupta N.R.
      Connector assembly to improve performance of the lighted stylet (Trachlight™) for nasotracheal intubation.
      ,
      • Zhang J.
      • Lamb A.
      • Hung O.
      • Hung C.
      • Hung D.
      Blind nasal intubation: teaching a dying art.
      ,
      • Hooker E.A.
      • Hagan S.
      • Coleman R.
      • Heine M.F.
      • Greenwood P.
      Directional-tip endotracheal tubes for blind nasotracheal intubation.
      ,
      • Dyson A.
      • Saunders P.R.
      • Giesecke A.H.
      Awake blind nasal intubation: use of a simple whistle.
      ,
      • Gorback M.S.
      Inflation of the endotracheal tube cuff as an aid to blind nasal endotracheal intubation.
      ).
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      References

        • Sharma R.
        • Kumar R.
        • Kumar S.
        • Gupta N.R.
        Connector assembly to improve performance of the lighted stylet (Trachlight™) for nasotracheal intubation.
        Anesth Analg. 2008; 107: 2095-2096
        • Zhang J.
        • Lamb A.
        • Hung O.
        • Hung C.
        • Hung D.
        Blind nasal intubation: teaching a dying art.
        Can J Anaesth. 2014; 61: 1055-1056
        • Hooker E.A.
        • Hagan S.
        • Coleman R.
        • Heine M.F.
        • Greenwood P.
        Directional-tip endotracheal tubes for blind nasotracheal intubation.
        Acad Emerg Med. 1996; 3: 586-589
        • Dyson A.
        • Saunders P.R.
        • Giesecke A.H.
        Awake blind nasal intubation: use of a simple whistle.
        Anaesthesia. 1990; 45: 71-72
        • Gorback M.S.
        Inflation of the endotracheal tube cuff as an aid to blind nasal endotracheal intubation.
        Anesth Analg. 1987; 66: 916-917