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Updated: Jul 15, 2025

Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
Published on: August 2, 2024
Awake endotracheal intubation using a hyperangulated video laryngoscope with a Total Control Introducer in a patient
Blake A Campbell1, Adam Dziuba1, Hunter Perala2
1Anesthesiology, University of Utah Health Hospitals and Clinics, Salt Lake City, Utah, USA.
Abstract:
We report the first use of a fully articulating introducer called the Total Control Introducer (TCI) in combination with a hyperangulated video laryngoscope (VL) to perform an awake intubation in a patient with a history of difficult intubation. After appropriate airway topicalisation, a VL with a hyperangulated blade was inserted to visualise the glottis. A TCI articulating introducer was then used to dynamically navigate through the oropharynx into the trachea. Under indirect visualisation, an endotracheal tube was then passed over the TCI. The TCI was removed and the endotracheal tube was secured. General anaesthesia was induced after confirmation of intubation with capnography and auscultation. The patient was successfully intubated on the first attempt without complications.
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