Related Experiment Video
Updated: Jan 11, 2026
03:58
Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
Published on: August 2, 2024
1.8K
Refining the Clinical Pathway for Nasotracheal Intubation: An Updated Decision Making Algorithm.
Mahesh Desilva1, Ramneek Maan1, Muhammad Helwany1
1Department of Anesthesia, Riverside Community Hospital, Riverside, CA 92501, USA.
Journal of Clinical Medicine
|November 13, 2025
Summary
This review updates nasotracheal intubation (NTI) techniques with a new algorithm for clinical decision-making. It covers epistaxis management and NTI conversion strategies, simplifying airway management.
Area of Science:
- Anesthesiology
- Emergency Medicine
- Otolaryngology
Background:
- Nasotracheal intubation (NTI) is a critical airway management technique.
- Existing NTI guidelines lack recent updates and a clear decision-making framework.
- Epistaxis is a common complication during NTI.
Purpose of the Study:
- To provide a comprehensive review of current NTI techniques.
- To introduce an updated, clinically applicable algorithmic approach to NTI.
- To detail strategies for managing epistaxis and converting orotracheal intubation (OTI) to NTI.
Main Methods:
- Systematic review of NTI literature.
- Development of a novel NTI decision-making algorithm.
- Categorization of OTI to NTI conversion techniques.
Main Results:
- An updated NTI algorithm simplifies choices to Routine Asleep NTI, Awake NTI, or OTI followed by NTI conversion.
- Comprehensive review of epistaxis control methods.
- Detailed analysis of direct and indirect OTI to NTI conversion pathways.
Conclusions:
- The new algorithm offers a methodical approach to NTI.
- Updated techniques and conversion strategies enhance NTI safety and efficacy.
- Visual aids, including animated videos, clarify complex conversion procedures.
Related Concept Videos
01:15Endotracheal Intubation I: Procedure
7.2K
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
7.2K
01:17Endotracheal Intubation II: Nursing Management
2.4K
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
2.4K
01:30Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
448
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
448
01:29Suctioning the Nasopharyngeal Airway
2.9K
Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
Equipment Required
Equipment Required
2.9K
01:16Tracheostomy Care I: Pre-procedural Steps
951
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
951
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
506
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
506