Nasal Intubation
Highlights
A. Thread the nasotracheal tube along the floor of the nose.
B. Never thread it toward the frontal sinus. (View Highlight)- The NTT tip tends to hand up in two places: passing the turbinates or turning into the pharynx. (View Highlight)
- Aim the bevel facing outward. This orientation allows the tip to slide along the septum and makes it less likely to tear mucosa or damage a turbinate. (View Highlight)
A. When the head is neutral during nasal intubation, the ETT bevel hits the posterior pharyngeal wall at 90 degrees, possibly preventing its turn toward the trachea.
B. Tilting the head into extension decreases the angle of impact and may allow it to slide downward more easily. (View Highlight)- Make Sure the ETT Cuff Is Below the Cricoid Ring
An endotracheal tube cuff inflated inside the cricoid ring can damage the trachea and potentially cause vocal cord paralysis. (View Highlight)
- Submucosal dissection can occur if the NTT tip tears and slides underneath the posterior pharyngeal mucosa. (View Highlight)
