Nasotracheal intubation

Blind nasotracheal intubation presumes a spontaneously breathing patient but offers a very useful alternative method to instrumented access to the airway and is used primarily in traumatized patients whose cervical spines are suspect. It has a high success rate (90-92 per cent), even when the operator is relatively inexperienced, and is associated with few complications (10 per cent or fewer); a rate that is lower when there is adequate time to prepare the patient with vasoconstrictor and topical anesthesia. The most common complication is epistaxis. Surgical methods of intubation also are discussed of which cricothyroidostomy currently enjoys prominence.