Clinical assessment of the Augustine Guide for endotracheal intubation

The Augustine Guide (AG) allows oral endotracheal intubations to be performed blindly; head and neck manipulation are unnecessary. It is a premolded device designed to fit in a lock and key fashion in the glottis, thus serving as a guide to allow blind laryngeal insertion of an endotracheal tube. Intubation success rate with the AG was studied in 100 adults intubated by the same individual; head and neck were held neutral. Intubations were described as easy if they were successful in the first attempt and difficult when more than one attempt to position the AG was necessary. Endotracheal intubation was successful 94% of the time and was easy in 71%. Repositioning of the AG was necessary in 23%. Patients with jaw abnormalities required repositioning more often (P < 0.05). Esophageal intubation did not occur. Minor trauma was noted in 18% of subjects. The AG is a safe and effective tool for blind orotracheal intubation.